CIGNA GROUP, 10-K filed on 2/23/2023
Annual Report
v3.22.4
Cover Page - USD ($)
$ in Billions
12 Months Ended
Dec. 31, 2022
Jan. 31, 2023
Jun. 30, 2022
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2022    
Current Fiscal Year End Date --12-31    
Document Transition Report false    
Entity File Number 001-38769    
Entity Registrant Name The Cigna Group    
Entity Incorporation, State or Country Code DE    
Entity Tax Identification Number 82-4991898    
Entity Address, Address Line One 900 Cottage Grove Road    
Entity Address, City or Town Bloomfield    
Entity Address, State or Province CT    
Entity Address, Postal Zip Code 06002    
City Area Code 860    
Local Phone Number 226-6000    
Title of 12(b) Security Common Stock, Par Value $0.01    
Trading Symbol CI    
Security Exchange Name NYSE    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
Entity Current Reporting Status Yes    
Entity Interactive Data Current Yes    
Entity Filer Category Large Accelerated Filer    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
Entity Shell Company false    
Entity Public Float     $ 82.8
Entity Common Stock, Shares Outstanding   297,059,973  
Documents Incorporated by Reference Part III of this Form 10-K incorporates by reference information from the registrant's definitive proxy statement related to the 2023 annual meeting of shareholders.    
Amendment Flag false    
Document Fiscal Period Focus FY    
Document Fiscal Year Focus 2022    
Entity Central Index Key 0001739940    
v3.22.4
Audit Information
12 Months Ended
Dec. 31, 2022
Audit Information [Abstract]  
Auditor Name PricewaterhouseCoopers LLP
Auditor Location Hartford, Connecticut
Auditor Firm ID 238
v3.22.4
Consolidated Statements of Income - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Revenues      
Premiums $ 39,915 $ 41,154 $ 42,627
Net investment income 1,155 1,549 1,244
TOTAL REVENUES 180,516 174,078 160,401
Benefits and expenses      
Pharmacy and other service costs 124,834 117,553 103,484
Medical costs and other benefit expenses 32,206 33,562 32,710
Selling, general and administrative expenses 13,186 13,030 14,072
Amortization of acquired intangible assets 1,876 1,998 1,982
TOTAL BENEFITS AND EXPENSES 172,102 166,143 152,248
Income from operations 8,414 7,935 8,153
Interest expense and other (1,228) (1,208) (1,438)
Debt extinguishment costs 0 (141) (199)
Gain on sale of businesses 1,662 0 4,203
Net realized investment (losses) gains (495) 196 149
Income before income taxes 8,353 6,782 10,868
TOTAL INCOME TAXES 1,607 1,367 2,379
Net income 6,746 5,415 8,489
Less: Net income attributable to noncontrolling interests 78 50 31
SHAREHOLDERS' NET INCOME $ 6,668 $ 5,365 $ 8,458
Shareholders' net income per share      
Basic (in dollars per share) $ 21.54 $ 15.87 $ 23.17
Diluted (in dollars per share) $ 21.30 $ 15.73 $ 22.96
Pharmacy revenues      
Revenues      
Revenues $ 128,566 $ 121,413 $ 107,769
Fees and other revenues      
Revenues      
Revenues $ 10,880 $ 9,962 $ 8,761
v3.22.4
Consolidated Statements of Comprehensive Income - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Statement of Comprehensive Income [Abstract]      
Net income $ 6,746 $ 5,415 $ 8,489
Other comprehensive income (loss), net of tax      
Net unrealized depreciation on securities and derivatives (1,005) (215) (75)
Net translation gains (losses) on foreign currencies 72 (232) 252
Postretirement benefits liability adjustment 420 410 (105)
Other comprehensive (loss) income, net of tax (513) (37) 72
Total comprehensive income 6,233 5,378 8,561
Comprehensive income (loss) attributable to noncontrolling interests      
Net income attributable to redeemable noncontrolling interests 11 19 14
Net income attributable to other noncontrolling interests 67 31 17
Other comprehensive loss attributable to redeemable noncontrolling interests (2) (14) (8)
Total comprehensive income attributable to noncontrolling interests 76 36 23
SHAREHOLDERS' COMPREHENSIVE INCOME $ 6,157 $ 5,342 $ 8,538
v3.22.4
Consolidated Balance Sheets - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Assets    
Cash and cash equivalents $ 5,924 $ 5,081
Investments 905 920
Accounts receivable, net 17,218 15,071
Inventories 4,777 3,722
Other current assets 1,296 1,283
Assets of businesses held for sale 0 10,057
Total current assets 30,120 36,134
Long-term investments 16,288 18,438
Reinsurance recoverables 4,743 4,970
Property and equipment 3,774 3,692
Goodwill 45,811 45,811
Other intangible assets 32,492 34,102
Other assets 3,426 3,405
Separate account assets 7,278 8,337
TOTAL ASSETS 143,932 154,889
Liabilities    
Current insurance and contractholder liabilities 5,385 5,318
Pharmacy and other service costs payable 17,070 15,309
Accounts payable 7,775 6,655
Accrued expenses and other liabilities 8,006 7,322
Short-term debt 2,993 2,545
Liabilities of businesses held for sale 0 6,423
Total current liabilities 41,229 43,572
Non-current insurance and contractholder liabilities 11,481 12,563
Deferred tax liabilities, net 7,751 8,346
Other non-current liabilities 3,142 3,762
Long-term debt 28,100 31,125
Separate account liabilities 7,278 8,337
TOTAL LIABILITIES 98,981 107,705
Contingencies — Note 23
Redeemable noncontrolling interests 66 54
Shareholders' equity    
Common stock [1] 4 4
Additional paid-in capital 30,233 29,574
Accumulated other comprehensive loss (1,395) (884)
Retained earnings 37,874 32,593
Less: Treasury stock, at cost (21,844) (14,175)
TOTAL SHAREHOLDERS' EQUITY 44,872 47,112
Other noncontrolling interests 13 18
Total equity 44,885 47,130
Total liabilities and equity $ 143,932 $ 154,889
[1] Par value per share, $0.01; shares issued, 398 million as of December 31, 2022 and 394 million as of December 31, 2021; authorized shares, 600 million.
v3.22.4
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Statement of Financial Position [Abstract]      
Common stock, par value (in dollars per share) $ 0.01 $ 0.01 $ 0.01
Common stock, shares issued (in shares) 397,819,000 394,194,000 390,276,000
Common stock, shares authorized (in shares) 600,000,000 600,000,000 600,000,000
v3.22.4
Consolidated Statements of Changes in Total Equity - USD ($)
$ in Millions
Total
Adjustment upon Adoption
Shareholders' Equity
Shareholders' Equity
Adjustment upon Adoption
Common Stock
Additional Paid-in Capital
Accumulated Other Comprehensive (Loss)
Retained Earnings
Retained Earnings
Adjustment upon Adoption
Treasury Stock
Other Non- controlling Interests
Balance at Dec. 31, 2019 $ 45,344 $ (30) $ 45,338 $ (30) $ 4 $ 28,306 $ (941) $ 20,162 $ (30) $ (2,193) $ 6
Changes in Total Equity [Roll Forward]                      
Effect of issuing stock for employee benefit plans 582   582     672       (90)  
Other comprehensive income (loss) 80   80       80        
Net income 8,475   8,458         8,458     17
Common dividends declared (15)   (15)         (15)      
Repurchase of common stock (4,089)   (4,089)             (4,089)  
Other transactions impacting noncontrolling interests (19)   (3)     (3)         (16)
Balance at Dec. 31, 2020 50,328   50,321   4 28,975 (861) 28,575   (6,372) 7
Balance at Dec. 31, 2019 35                    
Change in Redeemable Noncontrolling Interests                      
Other comprehensive loss (8)                    
Net income 14                    
Other transactions impacting noncontrolling interests 17                    
Balance at Dec. 31, 2020 $ 58                    
Change in Redeemable Noncontrolling Interests                      
Accounting Standards Update [Extensible List] Accounting Standards Update 2016-13 [Member]                    
Effect of issuing stock for employee benefit plans $ 511   511     604       (93)  
Other comprehensive income (loss) (23)   (23)       (23)        
Net income 5,396   5,365         5,365     31
Common dividends declared (1,347)   (1,347)         (1,347)      
Repurchase of common stock (7,710)   (7,710)             (7,710)  
Other transactions impacting noncontrolling interests (25)   (5)     (5)         (20)
Balance at Dec. 31, 2021 47,130   47,112   4 29,574 (884) 32,593   (14,175) 18
Change in Redeemable Noncontrolling Interests                      
Other comprehensive loss (14)                    
Net income 19                    
Other transactions impacting noncontrolling interests (9)                    
Balance at Dec. 31, 2021 54                    
Changes in Total Equity [Roll Forward]                      
Effect of issuing stock for employee benefit plans 583   583     659       (76)  
Other comprehensive income (loss) (511)   (511)       (511)        
Net income 6,735   6,668         6,668     67
Common dividends declared (1,387)   (1,387)         (1,387)      
Repurchase of common stock (7,593)   (7,593)             (7,593)  
Other transactions impacting noncontrolling interests (72)   0               (72)
Balance at Dec. 31, 2022 44,885   $ 44,872   $ 4 $ 30,233 $ (1,395) $ 37,874   $ (21,844) $ 13
Change in Redeemable Noncontrolling Interests                      
Other comprehensive loss (2)                    
Net income 11                    
Other transactions impacting noncontrolling interests 3                    
Balance at Dec. 31, 2022 $ 66                    
v3.22.4
Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares
3 Months Ended 12 Months Ended
Dec. 31, 2022
Sep. 30, 2022
Jun. 30, 2022
Mar. 31, 2022
Dec. 31, 2021
Sep. 30, 2021
Jun. 30, 2021
Mar. 31, 2021
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Statement of Stockholders' Equity [Abstract]                      
Common dividends declared (in dollars per share) $ 1.12 $ 1.12 $ 1.12 $ 1.12 $ 1.00 $ 1.00 $ 1.00 $ 1.00 $ 4.48 $ 4.00 $ 0.04
v3.22.4
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cash Flows from Operating Activities      
Net income $ 6,746 $ 5,415 $ 8,489
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 2,937 2,923 2,802
Realized investment losses (gains), net 495 (196) (149)
Deferred income tax benefit (480) (220) (386)
Gain on sale of businesses (1,662) 0 (4,203)
Debt extinguishment costs 0 141 199
Net changes in assets and liabilities, net of non-operating effects:      
Accounts receivable, net (2,237) (2,843) (1,496)
Inventories (1,055) (557) (504)
Reinsurance recoverable and Other assets (38) (656) (77)
Insurance liabilities 291 967 841
Pharmacy and other service costs payable 1,760 1,961 2,891
Accounts payable and Accrued expenses and other liabilities 1,574 (77) 1,346
Other, net 325 333 597
NET CASH PROVIDED BY OPERATING ACTIVITIES 8,656 7,191 10,350
Proceeds from investments sold:      
Debt securities and equity securities 1,744 2,030 2,283
Investment maturities and repayments:      
Debt securities and equity securities 1,327 1,628 1,519
Commercial mortgage loans 98 180 19
Other sales, maturities and repayments (primarily short-term and other long-term investments) 1,039 1,936 1,575
Investments purchased or originated:      
Debt securities and equity securities (2,756) (3,553) (4,765)
Commercial mortgage loans (161) (327) (113)
Other (primarily short-term and other long-term investments) (1,563) (2,554) (1,924)
Property and equipment purchases, net (1,295) (1,154) (1,094)
Acquisitions, net of cash acquired 0 (1,833) (139)
Divestitures, net of cash sold 4,835 (61) 5,592
Other, net (170) 97 23
NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES 3,098 (3,611) 2,976
Cash Flows from Financing Activities      
Deposits and interest credited to contractholder deposit funds 164 153 1,023
Withdrawals and benefit payments from contractholder deposit funds (220) (168) (979)
Net change in short-term debt (2,059) 975 60
Net proceeds on issuance of term loan 0 0 1,398
Repayment of term loan 0 0 (1,400)
Payments for debt extinguishment 0 (136) (212)
Repayment of long-term debt (500) (4,578) (8,047)
Net proceeds on issuance of long-term debt 0 4,260 3,465
Repurchase of common stock (7,607) (7,742) (4,042)
Issuance of common stock 389 326 376
Common stock dividend paid (1,384) (1,341) (15)
Other, net (23) 39 (160)
NET CASH USED IN FINANCING ACTIVITIES (11,240) (8,212) (8,533)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash (86) (65) 41
Net increase (decrease) in cash, cash equivalents and restricted cash 428 (4,697) 4,834
Cash, cash equivalents and restricted cash January 1, including held for sale assets [1] 5,548   5,411
Cash, cash equivalents and restricted cash December 31, including held for sale assets [1]   5,548  
Cash and cash equivalents reclassified to Assets of businesses held for sale 0 (425) 0
Cash, cash equivalents and restricted cash and cash equivalents January 1, [2] 5,123 10,245 [1]  
Cash, cash equivalents and restricted cash and cash equivalents December 31, [2] 5,976 5,123 10,245 [1]
Supplemental Disclosure of Cash Information:      
Income taxes paid, net of refunds 1,850 2,240 1,837
Interest paid $ 1,229 $ 1,253 $ 1,439
[1] Includes $425 million reported in Assets of businesses held for sale as of January 1, 2022.
[2] Restricted cash and cash equivalents were reported in other long-term investments.
v3.22.4
Consolidated Statements of Cash Flows (Parenthetical) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Statement of Cash Flows [Abstract]      
Cash, cash equivalents and restricted cash, reported in Assets of businesses held for sale $ 0 $ 425 $ 0
v3.22.4
Description of Business
12 Months Ended
Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Description of Business
Note 1 – Description of Business
The Cigna Group, together with its subsidiaries, is a global health company. On February 13, 2023, we changed our corporate name from Cigna Corporation to The Cigna Group. We will not distinguish between our prior and current corporate name and will refer to our current corporate name throughout the Financial Statements and related footnotes. As such, unless expressly indicated or the context requires otherwise, the terms "Company," "we," "us," and "our" in this document refer to The Cigna Group, a Delaware corporation, and, where appropriate, its subsidiaries. On February 13, 2023, we also changed the name of our Evernorth segment to Evernorth Health Services. We will not distinguish between our prior and current segment name and will refer to our current segment name throughout the Financial Statements and related footnotes. Our common stock continues to be listed with, and trades on, the New York Stock Exchange under the ticker symbol "CI". The Cigna Group has a mission of helping those we serve improve their health and vitality. Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and supplemental products and services.

The majority of these products are offered through employers and other groups such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers commercial health and dental insurance and Medicare products to individuals in the United States and selected international markets. In addition to these ongoing operations, The Cigna Group also has certain run-off operations.
A full description of our segments follows:
Evernorth Health Services includes 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, Home Delivery Pharmacy, Specialty Pharmacy, Distribution and Care Delivery and Management Solutions, which are provided to health plans, employers, government organizations and health care providers.
Cigna Healthcare includes the U.S. Commercial, U.S. Government and International Health operating segments which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental and other products and services for insured and self-insured clients. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.
Other Operations comprises the remainder of our business operations, which includes ongoing businesses and exiting businesses. Our ongoing businesses include continuing business, corporate-owned life insurance ("COLI") and our run-off businesses. Our run-off businesses include (i) guaranteed minimum death benefit ("GMDB") and guaranteed minimum income benefit ("GMIB") business that was effectively exited through reinsurance with Berkshire Hathaway Life Insurance Company of Nebraska ("Berkshire") in 2013, (ii) settlement annuity business, and (iii) individual life insurance and annuity and retirement benefits businesses comprised of deferred gains from the sales of these businesses. Our exiting businesses include our interest in a joint venture in Türkiye, which was sold to our partner in December 2022, the international life, accident and supplemental benefits businesses sold on July 1, 2022, and the Group Disability and Life business sold on December 31, 2020.
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 and Thailand) to Chubb INA Holdings, Inc. ("Chubb") for approximately $5.4 billion in cash (the "Chubb transaction") (see Note 4).

Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate debt less net investment income on investments not supporting segment and other operations), certain litigation matters, expense associated with our frozen pension plans, charitable contributions, operating severance, certain overhead and enterprise-wide project costs and intersegment eliminations for products and services sold between segments.
v3.22.4
Summary of Significant Accounting Policies
12 Months Ended
Dec. 31, 2022
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies
Note 2 – Summary of Significant Accounting Policies    
Basis of Presentation
The Consolidated Financial Statements include the accounts of The Cigna Group and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP"). Certain amounts in prior years have been reclassified to conform to the current year presentation.
Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.
Recent Accounting Pronouncements
There were no new accounting standards adopted during the year ended December 31, 2022 that had a material impact on our Consolidated Financial Statements.
Accounting Guidance Not Yet Adopted
Targeted Improvements to the Accounting for Long-Duration Contracts (ASU 2018-12) and related amendments ("LDTI")
Effective date of January 1, 2023 for The Cigna Group and requires the following key provisions (for insurance entities that issue long-duration contracts):

Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:
Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) to be updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.
Discount rate assumptions to be updated quarterly based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed-income instrument yield is interpreted to mean A-rated.
Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts to be amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.
Market risk benefits (defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk) to be measured at fair value, with changes in fair value recognized in net income each period, except for the effect of changes in the insurance entity's credit risk to be recognized in other comprehensive income.
Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.
Transition methods at adoption vary:
Changes to the liability for future policy benefits and DAC to use a modified retrospective approach applied to all outstanding contracts on the basis of their existing carrying amounts as of the beginning of the earliest period presented, with an option to elect a full retrospective transition under certain criteria. Remeasuring the future policy benefits liability for the discount rate to be recorded through accumulated other comprehensive loss at transition.
Market risk benefits to be transitioned retrospectively and measured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value to be recognized in the opening balance of retained earnings, excluding the effect of credit risk changes that are to be recognized in accumulated other comprehensive loss.
Expected effects:
The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.
The Company developed a cross-functional implementation project plan and executed on the necessary changes to our systems, processes and controls.
The Company adopted the standard on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and DAC. The impact of adoption was not material to Shareholders' equity and did not result in a material restatement of prior periods.
It is possible that our income recognition pattern could change on a prospective basis for several reasons:
Applying periodic assumption updates, versus the current locked-in model, may change our timing of profit or loss recognition.
DAC amortization will be on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.
Features, such as the Company's GMDB product, that provide market-risk benefits are not currently measured at fair value, so these liabilities and related reinsurance recoverables will become subject to market sensitivity, notably to interest rates.
In December 2022, the Financial Accounting Standards Board ("FASB") published Accounting Standards Update (ASU) 2022-05, which simplifies the retrospective adoption of LDTI. The ASU permits companies to make an accounting policy election to exclude contracts that are sold and removed from the balance sheet prior to the effective date of the standard from the retrospective adoption of LDTI. The Cigna Group made this policy election for the contracts sold in the Chubb transaction and our divested interest in a joint venture in Türkiye.
Significant Accounting Policies
The Company's accounting policies are described either in this Note or in the applicable Notes to the Consolidated Financial Statements as listed in the table of contents on page 83.
A.Cash and Cash Equivalents
Cash and cash equivalents are carried at cost that approximates fair value. Cash equivalents consist of short-term investments with maturities of three months or less from the time of purchase. The Company reclassifies cash overdraft positions to liabilities when the legal right of offset does not exist.
B.Inventories
Inventories consist of prescription drugs and medical supplies and are stated at the lower of first-in-first-out cost or net realizable value.
Deferred Policy Acquisition Costs
Costs eligible for deferral, recorded within Other assets (non-current), include incremental, direct costs of acquiring new or renewal insurance and investment contracts and other costs directly related to successful contract acquisition. Examples of deferrable costs include commissions, sales compensation and benefits, policy issuance and underwriting costs. The Company records acquisition costs differently depending on the product line. Acquisition costs for:
Supplemental health, life and accident insurance products (primarily individual products) that comprise the majority of the Company's deferred policy acquisition costs and group health and accident insurance products are deferred and amortized, generally in proportion to the ratio of periodic revenue to the estimated total revenues over the contract periods.
Universal life products are deferred and amortized in proportion to the present value of total estimated gross profits over the expected lives of the contracts.
Other products are expensed as incurred.
Deferred policy acquisition costs also include the value of business acquired ("VOBA") for certain acquisitions with material long-duration insurance contracts. The Company recorded amortization of deferred policy acquisition costs of $319 million in 2022, $478 million in 2021 and $502 million in 2020 primarily in Selling, general and administrative expenses.
Each year, deferred policy acquisition costs are tested for recoverability. For universal life and other individual products, management estimates the present value of future revenues less expected payments. For group health and accident insurance products, management estimates the sum of unearned premiums and anticipated net investment income less future expected claims and related costs. If management's estimates of these sums are less than the deferred costs, the Company reduces deferred policy acquisition costs and records an additional expense.
Other Assets (Current and Non-Current)
Other current assets consist primarily of prepaid expenses, accrued investment income, the current portion of reinsurance recoverables and income tax receivables. Other assets (non-current) consist primarily of the carrying value of our equity-method investments in business-related joint ventures in China, India, the U.S. and other foreign jurisdictions. Earnings or losses from these equity-method investments in joint ventures are recorded in Fees and other revenues. See Note 14 for additional information on unconsolidated subsidiaries. Additionally, Other assets (non-current) include deferred policy acquisition costs, operating lease right-of-use assets, GMIB assets, overfunded pension obligations (see Note 17) and various other insurance-related assets. See Note 10 for the Company's accounting policy for GMIB assets and Note 20 for the Company's accounting policy related to leases.
E.Redeemable Noncontrolling Interests
Redeemable noncontrolling interests in our Consolidated Balance Sheets represents the noncontrolling shareholders' preferred and common stock interests of the Company's consolidated less than fully owned subsidiaries. Those shareholders may choose to require
the Company to purchase their equity interest. For certain entities, we may also have the right to require those shareholders to sell their equity interest to us. As these redeemable noncontrolling interests provide for redemption features not solely within our control, we classify the redeemable noncontrolling interests outside of permanent equity. The noncontrolling interest was initially recorded at fair value. In subsequent reporting periods, the values are adjusted to reflect the earnings, losses and distributions attributable to the noncontrolling interest. When a shareholder's right to require the Company to purchase its equity interest is exercisable, the redeemable noncontrolling interest is recorded at estimated redemption value. When the estimated redemption value for a redeemable noncontrolling interest exceeds its initial carrying value, an adjustment to increase or decrease the redeemable noncontrolling interest is recorded with an offsetting adjustment to Retained earnings or Additional paid-in capital in the absence of Retained earnings. When an adjustment is made to the carrying value of the redeemable noncontrolling interest, the calculation of shareholders' net income per share will be adjusted if the redemption value exceeds fair value.
F.Accrued Expenses and Other Current and Non-Current Liabilities
Accrued expenses and other liabilities (current) primarily includes financial and performance guarantee liabilities under pharmacy contracts (see section H), management compensation and various insurance-related liabilities, including experience-rated refunds, reinsurance contracts and the risk adjustment and minimum medical loss ratio rebate accruals under The Patient Protection and Affordable Care Act (the "ACA"). Other non-current liabilities primarily include uncertain tax positions (see Note 22), GMIB contract liabilities (see Note 10), lease liabilities (see Note 20), self-insured exposures not expected to be settled within one year and underfunded pension obligations (see Note 17).
The Company accrues for legal and regulatory matters when a loss contingency is both probable and estimable. The estimated loss is generally recorded in Selling, general and administrative expenses and represents the Company's best estimate of the loss contingency. If the loss estimate is a range, the Company accrues the minimum amount in the range if no amount is better than any other estimated amount in the range. Legal costs to defend the Company's litigation and arbitration matters are expensed as incurred in cases that the Company cannot reasonably estimate the ultimate cost to defend. If the Company can reasonably estimate the cost to defend, a liability for these costs is accrued when the claim is reported. Litigation and legal or regulatory matters that the Company has identified with a reasonable possibility of material loss are described in Note 23.
G.Translation of Foreign Currencies
The Company generally conducts its international business through foreign operating entities that maintain assets and liabilities in local currencies that are their functional currencies. The Company uses exchange rates as of the balance sheet date to translate assets and liabilities into U.S. dollars. Translation gains or losses on functional currencies, net of applicable taxes, are recorded in Accumulated other comprehensive loss. The Company uses average monthly exchange rates during the year to translate revenues and expenses into U.S. dollars.
H.Pharmacy Revenues and Costs
Pharmacy revenues. Pharmacy revenues are primarily derived from providing pharmacy benefit management services to clients and customers. Pharmacy revenues are recognized when control of the promised goods or services is transferred to clients and customers, in an amount that reflects the consideration the Company expects to receive for those goods or services.
The Company provides or makes available various services supporting benefit management and claims administration and is generally obligated to provide prescription drugs to clients' members using multiple distribution methods including retail networks, home delivery and specialty pharmacies. These goods and services are integrated into a single performance obligation to process claims, dispense prescription drugs and provide other services over the contract period (generally three years). This performance obligation is satisfied as the business stands ready to fulfill its obligation.
Revenues for dispensing prescription drugs through retail pharmacies are reported gross and consist of the prescription price (ingredient cost and dispensing fee) contracted with clients, including the customer copayment and any associated fees for services, because the Company acts as the principal in these arrangements. When a prescription is presented to a retail network pharmacy, the Company is solely responsible for customer eligibility, drug utilization review, drug-to-drug interaction review, any required clinical intervention, plan provision information, payment to the pharmacy and client billing. These revenues are recognized based on the full prescription price when the pharmacy claim is processed and approved for payment. The Company also provides benefit design and formulary consultation services to clients and negotiates separate contractual relationships with clients and network pharmacies. These factors indicate that the Company has control over these transactions until the prescription is processed. Revenues are billed, due and recognized at contract rates either on a periodic basis or as services are provided (such as based on volume of claims processed). This recognition pattern aligns with the benefits from services provided.
Home delivery and specialty pharmacy revenues are due and recognized as each prescription is shipped, net of reserves for discounts and contractual allowances estimated based on historical experience. Any differences between estimates and actual collections are reflected in Pharmacy revenues when payments are received. Historically, adjustments to original estimates and returns have not been material. The Company has elected the practical expedient to account for shipping and handling as a fulfillment activity.
We may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid at the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. The liability for these financial and performance guarantees was $1.3 billion as of December 31, 2022 and $1.1 billion as of December 31, 2021.
The Company administers programs through which we may receive rebates and other vendor consideration from pharmaceutical manufacturers. The amounts of such rebates or other vendor consideration shared with pharmacy benefit management services clients vary based on the contractual arrangement with the client and in some cases the type of consideration received from the pharmaceutical manufacturer. Rebates and other vendor consideration payable to pharmacy benefit management services clients are recorded as a reduction of Pharmacy revenues. Estimated amounts payable to clients are based on contractual sharing arrangements between the Company and the client and these amounts are adjusted when amounts are collected from pharmaceutical manufacturers in accordance with the contractual arrangement between the Company and the client. Historically, these adjustments have not been material.
In retail, home delivery and specialty transactions, amounts may be collected from third-party payors. These are billed and collected in accordance with the Company's standard accounts receivable collection procedures.
Other pharmacy service revenues are earned by distributing specialty pharmaceuticals and medical supplies to providers, clinics and hospitals. These revenues are billed, due and recognized at contracted rates as prescriptions and supplies are shipped and services are provided.
Pharmacy costs. Pharmacy costs include the cost of prescriptions sold, network pharmacy claim costs and copayments. Also included are direct costs of dispensing prescriptions including supplies, shipping and handling and direct costs associated with clinical programs, such as drug utilization management and medication adherence counseling. Home delivery and specialty pharmacy costs are recognized when the drug is shipped and retail network costs are recognized when the drug is processed and approved for payment. Rebates and other vendor consideration received when providing pharmacy benefit management services are recorded as a reduction of pharmacy costs. Rebates are recognized as prescriptions are shipped or processed and approved for payment. Historically, the effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected, net of contractual allowances, has not been material. The Company maintains reimbursement guarantees with certain retail network pharmacies. For each such guarantee, the Company records a pharmacy and other service costs payable or prepaid asset for applicable retail network claims based on our actual performance throughout the period against the contractual reimbursement rate. The Company's contracts with certain retail pharmacies give the Company the right to adjust reimbursement rates during the annual guarantee period.
Other. Incremental costs of obtaining service and pharmacy contracts for short-term arrangements are expensed as incurred.
I.Premiums and Related Expenses
Premiums for short-duration group health, accident and life insurance and managed care coverages are recognized as revenue on a pro rata basis over the contract period. Benefits and expenses are recognized when incurred and, for our Cigna Healthcare business, are presented net of pharmaceutical manufacturer rebates. For experience-rated contracts, premium revenue includes an adjustment for experience-rated refunds based on contract terms and calculated using the customer's experience (including estimates of incurred but not reported claims).
Premiums received for the Company's Medicare Advantage plans, Medicare Part D products and Individual and Family Plans from the Centers for Medicare and Medicaid Services ("CMS") and customers are recognized as revenue ratably over the contract period.
CMS provides risk-adjusted premium payments for Medicare Advantage Plans and Medicare Part D products based on our customer demographics and medical diagnoses, which may change from period to period based on the underlying health of our customers. The Company recognizes changes to risk-adjusted premiums as revenue when the amounts are determinable and collection is reasonably assured. Revenue adjustments are generally settled semi-annually with CMS. The final revenue adjustment is generally settled with CMS in the year following the contract year.
Medicare Part D premiums include payments from CMS for risk-sharing adjustments that are estimated quarterly based on claim experience by comparing actual incurred prescription drug costs to the estimated costs submitted in the original contracts. These
adjustments may result in more or less revenue from CMS. Final revenue adjustments generally occur in the year following the contract year.
The ACA prescribed a risk-adjustment program to mitigate the risk for participating health insurance companies selling coverage on the public exchanges. The risk-adjustment program reallocates funds from insurers with lower risk populations to insurers with higher risk populations based on the relative risk scores of participants. We estimate our receivable or payable based on the risk of our customers compared to the risk of other customers in the same state and market, considering data obtained from industry studies and the United States Department of Health and Human Services ("HHS"). Receivables or payables are recorded as adjustments to premium revenue based on our year-to-date experience when the amounts are reasonably estimable and collection is reasonably assured. Final revenue adjustments are determined by HHS in the year following the policy year.
Premium revenue may also include an adjustment to reflect the estimated effect of rebates due to customers under medical loss ratio provisions of the ACA. These rebate liabilities are settled in the subsequent year.
Premiums for long-duration insurance contracts, including individual life, accident and supplemental health insurance and annuity products, and excluding universal life and investment-related products, are recognized as revenue when due. Benefits and expenses are matched with premiums.
Revenue for universal life products is recognized as follows:
Investment income on assets supporting universal life products is recognized in Net investment income as earned.
Charges for mortality, administration and policy surrender are recognized in Premiums as earned. Administrative fees are considered earned when services are provided.
Benefits and expenses for universal life products consist of benefit claims in excess of policyholder account balances and income earned by policyholders. Expenses are recognized when claims are incurred and income is credited to policyholders in accordance with contract provisions.
The unrecognized portion of premiums received is recorded as unearned premiums included in Insurance and contractholder liabilities (current and non-current) (see Note 9 for further information).
J.Fees and Related Expenses
The majority of the Company's service fees are derived from administrative services only ("ASO") arrangements, fee-for-service clinical solutions, Wholesale Marketplace Drug Formulary Management services, health benefit management services and administration of services to specialty pharmacy manufacturers.
ASO arrangements allow plan sponsors to self-fund claims and assume the risk of medical or other benefit costs. Most of the Company's ASO arrangements are for medical and specialty services, including pharmacy benefits. Generally, the Company's ASO arrangements are short-term. Contract modifications typically occur on renewal and are prospective in nature.
In return for fees from these clients, the Company provides access to our participating provider networks and other services supporting benefit management, including claims administration, behavioral health services, disease management, utilization management and cost containment programs. In general, the Company considers these services to be a combined performance obligation to provide cost effective administration of plan benefits over the contract period. Fees are billed, due and recognized monthly at contracted rates based on current membership or utilization. This recognition pattern aligns with the benefits from services provided to clients. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income.
The Company may also provide performance guarantees that provide potential refunds to clients if certain service standards, clinical outcomes or financial metrics are not met. If these standards, outcomes and metrics are not met, the Company may be financially at risk up to a stated percentage of the contracted fee or a stated dollar amount. The Company defers revenue by recording a liability for estimated payouts associated with these guarantees within Accrued expenses and other liabilities. The amount of revenue deferred is estimated for each type of guarantee using either a most likely amount or expected value method depending on the nature of the guarantee and the information available to estimate refunds. Estimates are refined each reporting period as additional information on the Company's performance becomes available and upon final reconciliation and settlement following the guarantee period. Amounts accrued and paid for these performance guarantees during the reporting periods were not material.
Expenses associated with administrative programs and services are recognized as incurred in Selling, general and administrative expenses.
The Company also earns revenue, as part of its integrated pharmacy benefits performance obligation, by offering fee-for-service clinical solutions to our clients, such as drug utilization management and medication adherence counseling. These clinical programs help clients to drive better health outcomes at a lower cost by identifying and addressing potentially unsafe or wasteful prescribing, dispensing and utilization of prescription drugs and communicating with, or supporting communications with physicians, pharmacies and patients. Fees are billed, due and recognized at contracted rates either on a periodic basis or as services are provided. This recognition pattern aligns with the benefits from services provided. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded as incurred in Selling, general and administrative expenses.
The Company earns fees from our Wholesale Marketplace Drug Formulary Management services. These services include either our drug formulary administrative service arrangements or our formulary processing arrangements. Drug formulary administrative services may include formulary consultation, administration of rebate contracts, rebate submission, collection from drug manufacturers and the distribution of rebates to clients. Services may also include facilitating audits of data submissions and reporting of rebates to clients. Clients agree to pay administrative fees that are billed, due and recognized at contracted rates as services are performed. These revenues are reported gross in Fees and other revenues and associated costs are reported in Pharmacy and other service costs in the Consolidated Statements of Income. For certain other clients in our formulary processing arrangements, the Company does not control the right to retain rebates before they are transferred to the client for services performed. Clients agree to allow the Company to retain a portion of each rebate collected in exchange for formulary processing services provided. These drug formulary service and administrative fee revenues are reported net in Fees and other revenues in the Consolidated Statements of Income. Revenue is recognized as rebates are processed.
The Company also earns fees by providing health benefit management solutions that drive cost reductions and improve quality outcomes. Clients are primarily sponsors of health benefit plans and fees may be stated as a per-member-per-month fee or as a per-claim fee. The Company considers the services to be a single performance obligation to stand ready to provide utilization management services over the contract period (generally three years). In certain arrangements, the Company assumes the financial obligation for third-party provider costs for medical services provided to the health plan's customers. Fees are recorded gross in Fees and other revenues in the Consolidated Statements of Income because the Company is acting as a principal in arranging for and controlling the services provided by third-party network providers. Contractual fees vary based on enrollment and provider costs and are billed, due and recognized monthly. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded in Selling, general and administrative expenses as incurred.
Certain health benefit management contracts require the Company to share the results of medical cost experience that differ from specified targets. This variable consideration is estimated at contract inception and adjusted through the contract period. The estimated profits and costs are recognized net in Fees and other revenues.
The Company also earns other service fees related to administrating services to specialty pharmacy manufacturers that are recorded in Fees and other revenues in the Consolidated Statements of Income. These revenues are billed, due and recognized at contracted rates as services are provided.
v3.22.4
Accounts Receivable, Net
12 Months Ended
Dec. 31, 2022
Receivables [Abstract]  
Accounts Receivable, Net Note 3 – Accounts Receivable, Net
Accounting policy. We bill pharmaceutical manufacturers based on management's interpretation of contractual terms and estimate a contractual allowance based on the best information available at the time a claim is processed. Contractual allowances for certain rebates receivable from pharmaceutical manufacturers are determined by reviewing payment experience and specific known items that could be adjusted under contract terms. The Company's estimation process for contractual allowances for pharmaceutical manufacturer receivables generally results in an allowance for balances outstanding greater than 90 days.
Contractual allowances for certain receivables from third-party payors are based on their contractual terms and are estimates based on the Company's best information available at the time revenue is recognized.
Allowances, discounts and claims adjustments issued to customers in the form of client credits and other non-credit adjustments are based on the current status of each customer's receivable balance, current economic and market conditions and a variety of other factors, including the length of time the receivables are past due, the financial health of customers and our past experience.
The allowance for expected credit losses for current accounts receivable is based primarily on past collections experience relative to the length of time receivables are past due; however, when available evidence reasonably supports an assumption that counterparty credit risk over the expected payment period will differ from current and historical payment collections, a forecasting adjustment is reflected in the allowance for expected credit losses.
Receivables and any associated allowance are written off only when all collection attempts have failed and such amounts are determined unrecoverable. We regularly review the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted.

The Company's accounts receivable include amounts due from pharmaceutical manufacturers, clients, third-party payors and customers, and are presented net of allowances. These balances include:

Pharmaceutical manufacturers receivables - amounts due from pharmaceutical manufacturers.
Noninsurance customer receivables - amounts due from customers for noninsurance services, primarily pharmacy benefit management and ASO contracts.
Insurance customer receivables - amounts due from customers under insurance and managed care contracts, primarily premiums receivable and amounts due from CMS.
Other receivables - all other accounts receivable not included in the categories above.
The following amounts were included within Accounts receivable, net:
(In millions)December 31, 2022December 31, 2021
Pharmaceutical manufacturers receivables$7,108 $5,463 
Noninsurance customer receivables6,899 6,274 
Insurance customer receivables2,963 2,932 
Other receivables248 456 
Total15,125 
Accounts receivable, net classified as Assets of businesses held for sale
(54)
Accounts receivable, net per Consolidated Balance Sheets$17,218 $15,071 
These receivables are reported net of our allowances of $1.9 billion as of December 31, 2022 and $1.4 billion as of December 31, 2021 as follows:
Included in our Pharmaceutical manufacturers receivables are contractual allowances for certain rebates receivable with pharmaceutical manufacturers of $1.3 billion as of December 31, 2022 and $926 million as of December 31, 2021.
Included in our Noninsurance customer receivables are contractual allowances from third-party payors of $336 million as of December 31, 2022 and $321 million as of December 31, 2021 based upon the contractual payment terms.
The remaining allowances of $226 million as of December 31, 2022 and $186 million as of December 31, 2021 include allowances, discounts and claims adjustments issued to customers in the form of client credits, an allowance for current expected credit losses and other non-credit adjustments.
The Company's allowance for current expected credit losses was $86 million as of December 31, 2022 and $60 million as of December 31, 2021.
v3.22.4
Mergers, Acquisitions and Divestitures
12 Months Ended
Dec. 31, 2022
Business Combination and Asset Acquisition [Abstract]  
Mergers, Acquisitions and Divestitures Note 4 – Mergers, Acquisitions and Divestitures Divestiture of International Businesses
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 and Thailand) to Chubb for approximately $5.4 billion in cash. The Company recognized a gain of $1.7 billion pre-tax ($1.4 billion after-tax), which includes recognition of previously unrealized capital losses on investments sold and translation loss on foreign currencies (see Note 15 for further information). Also see Note 5 for further information regarding the assets and liabilities of these divested businesses.

In December 2022, the Company also divested its ownership interest in a joint venture in Türkiye.
Divestiture of Group Disability and Life BusinessOn December 31, 2020, the Company completed the sale of its Group Disability and Life business to New York Life Insurance Company for cash proceeds of $6.2 billion. The Company recognized a gain of $4.2 billion pre-tax ($3.2 billion after-tax), which included recognition of previously unrealized capital gains on investments sold (see Note 15 for further information).Integration and Transaction-related CostsAs part of our strategic plan, we incurred non-routine costs associated with the disposition and acquisition of certain businesses. In 2022 and 2021, the Company incurred costs related to the Chubb transaction, the sale of the Group Disability and Life business, acquisition of MDLIVE and the terminated merger with Elevance Health, Inc. ("Elevance"), formerly known as Anthem, Inc. In 2020, the Company incurred costs related to the acquisition and integration of Express Scripts Holding Company ("Express Scripts"), the terminated merger with Elevance, the sale of the Group Disability and Life business and other transactions. These costs were $135 million pre-tax ($103 million after-tax) for the year ended December 31, 2022, compared with $169 million pre-tax ($71 million after-tax) for the year ended December 31, 2021 and $527 million pre-tax ($404 million after-tax) for the year ended December 31, 2020. These costs consisted primarily of certain projects to separate or integrate the Company's systems, products and services, fees for legal, advisory and other professional services and certain employment-related costs. After-tax costs for the year ended December 31, 2021 included a tax benefit from the resolution of a tax matter related to the sold Group Disability and Life business.
v3.22.4
Assets and Liabilities of Businesses Held for Sale
12 Months Ended
Dec. 31, 2022
Discontinued Operations and Disposal Groups [Abstract]  
Assets and Liabilities of Business Held for Sale Note 5 – Assets and Liabilities of Businesses Held for SaleAccounting policy. The Company classifies assets and liabilities as held for sale ("disposal group") when management commits to a plan to sell the disposal group, the sale is probable within one year and the disposal group is available for immediate sale in its present condition. The Company considers various factors, particularly whether actions required to complete the plan indicate it is unlikely that significant changes to the plan will be made or the plan will be withdrawn. Assets held for sale are measured at the lower of carrying value or fair value less costs to sell. Any loss resulting from the measurement is recognized in the period the held-for-sale criteria are met. Conversely, gains are not recognized until the date of the sale. When the disposal group is classified as held for sale, depreciation and amortization for most long-lived assets ceases and the Company tests the assets for impairment. Deferred policy acquisition costs continue to be amortized.On July 1, 2022, the Company completed the sale of its life, accident and supplemental benefits businesses in six countries to Chubb for approximately $5.4 billion in cash. Additionally, in December 2022, the Company divested its interest in a joint venture in Türkiye. See Note 4 for additional information. The Company aggregated and classified the assets and liabilities of these businesses as held for sale in our Consolidated Balance Sheets as of December 31, 2021.
The assets and liabilities of businesses held for sale were as follows:
(In millions)December 31, 2021
Cash and cash equivalents$406 
Investments5,109 
Deferred policy acquisition costs2,755 
Separate account assets878 
Goodwill, other intangible assets and all other assets909 
Total assets of businesses held for sale10,057 
Insurance and contractholder liabilities4,644 
Accounts payable, accrued expenses and other liabilities452 
Deferred tax liabilities, net449 
Separate account liabilities878 
Total liabilities of businesses held for sale$6,423 
The held for sale businesses reported Gross unrealized appreciation on securities and derivatives of $137 million and Gross cumulative translation losses on foreign currencies of $209 million within Accumulated other comprehensive loss in our Consolidated Balance Sheets as of December 31, 2021.

These amounts, as well as subsequent activity through the sale dates, were recognized within Gain on sale of businesses in our Consolidated Statements of Income as of December 31, 2022, as described in Note 4.
v3.22.4
Earnings Per Share
12 Months Ended
Dec. 31, 2022
Earnings Per Share [Abstract]  
Earnings Per Share Note 6 – Earnings Per ShareAccounting policy. The Company computes basic earnings per share using the weighted-average number of unrestricted common and deferred shares outstanding. Diluted earnings per share also includes the dilutive effect of outstanding employee stock options and restricted stock using the treasury stock method and the effect of strategic performance shares.Basic and diluted earnings per share were computed as follows:
For the Years Ended December 31,
202220212020
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution
DilutedBasicEffect of
Dilution
DilutedBasicEffect of
Dilution
Diluted
Shareholders' net income$6,668 $6,668 $5,365 $5,365 $8,458 $8,458 
Shares:
Weighted average309,546 309,546 337,962 337,962 364,979 364,979 
Common stock equivalents3,519 3,519 3,004 3,004 3,410 3,410 
Total shares309,546 3,519 313,065 337,962 3,004 340,966 364,979 3,410 368,389 
Earnings per share$21.54 $(0.24)$21.30 $15.87 $(0.14)$15.73 $23.17 $(0.21)$22.96 
The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive:
For the Years Ended December 31,
(In millions)202220212020
Anti-dilutive options1.0 1.5 4.1 
v3.22.4
Debt
12 Months Ended
Dec. 31, 2022
Debt Disclosure [Abstract]  
Debt
Note 7 – Debt
The outstanding amounts of debt, net of issuance costs, discounts or premiums, and finance leases were as follows:
(In millions)December 31, 2022December 31, 2021
Short-term debt
Commercial paper$ $2,027 
$500 million, 3.05% Notes due November 2022
 495 
$17 million, 8.3% Notes due January 2023
17 — 
$63 million, 7.65% Notes due March 2023
63 — 
$700 million, Floating Rate Notes due July 2023
700 — 
$1,000 million, 3.0% Notes due July 2023
994 — 
$1,187 million, 3.75% Notes due July 2023
1,186 — 
Other, including finance leases33 23 
Total short-term debt$2,993 $2,545 
Long-term debt
$17 million, 8.3% Notes due January 2023
$ $17 
$63 million, 7.65% Notes due March 2023
 63 
$700 million, Floating Rate Notes due July 2023
 699 
$1,000 million, 3% Notes due July 2023
 985 
$1,187 million, 3.75% Notes due July 2023
 1,185 
$500 million, 0.613% Notes due March 2024
499 498 
$1,000 million, 3.5% Notes due June 2024
990 983 
$900 million, 3.25% Notes due April 2025 (1)
872 897 
$2,200 million, 4.125% Notes due November 2025
2,195 2,193 
$1,500 million, 4.5% Notes due February 2026
1,503 1,504 
$800 million, 1.25% Notes due March 2026
797 796 
$1,500 million, 3.4% Notes due March 2027
1,436 1,423 
$259 million, 7.875% Debentures due May 2027
259 259 
$600 million, 3.05% Notes due October 2027
597 596 
$3,800 million, 4.375% Notes due October 2028
3,785 3,782 
$1,500 million, 2.4% Notes due March 2030
1,492 1,490 
$1,500 million, 2.375% Notes due March 2031 (1)
1,380 1,500 
$45 million, 8.3% Step Down Notes due January 2033 (2)
45 45 
$190 million, 6.15% Notes due November 2036
190 190 
$2,200 million, 4.8% Notes due August 2038
2,192 2,192 
$750 million, 3.2% Notes due March 2040
743 743 
$121 million, 5.875% Notes due March 2041
119 119 
$448 million, 6.125% Notes due November 2041
488 490 
$317 million, 5.375% Notes due February 2042
315 315 
$1,500 million, 4.8% Notes due July 2046
1,466 1,465 
$1,000 million, 3.875% Notes due October 2047
989 988 
$3,000 million, 4.9% Notes due December 2048
2,968 2,967 
$1,250 million, 3.4% Notes due March 2050
1,236 1,236 
$1,500 million, 3.4% Notes due March 2051
1,478 1,477 
Other, including finance leases66 28 
Total long-term debt$28,100 $31,125 
(1) The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 for further information about the Company's interest rate risk management and these derivative instruments.
(2) Interest rate step down to 8.08% effective January 15, 2023.
Short-term and Credit Facilities Debt
Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including for the purpose of providing liquidity support if necessary under our commercial paper program discussed below. As of December 31, 2022, there were no outstanding balances under these revolving credit agreements.
In April 2022, The Cigna Group entered into the following revolving credit agreements (the "Credit Agreements"):
a $3.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2027 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $3.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.
a $1.0 billion three-year revolving credit agreement that will mature in April 2025 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $1.0 billion under the credit agreement for general corporate purposes.
a $1.0 billion 364-day revolving credit agreement that will mature in April 2023. The Company can borrow up to $1.0 billion under the credit agreement for general corporate purposes. This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.
Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $1.5 billion across all three facilities for a maximum total commitment of $6.5 billion. The Credit Agreements allow for borrowings at either a base rate or an adjusted term Secured Overnight Funding Rate ("SOFR") plus, in each case, an applicable margin based on the Company's senior unsecured credit ratings.

Each of the three facilities is diversified among 22 banks. Each facility also contains customary covenants and restrictions, including a financial covenant that the Company's leverage ratio, as defined in the Credit Agreements, may not exceed 60%, subject to certain exceptions upon the consummation of an acquisition.

The Credit Agreements replaced a prior $3.0 billion five-year revolving credit and letter of credit agreement maturing on April 2026, a $1.0 billion three-year revolving credit agreement maturing on April 2024 and a $1.0 billion 364-day revolving credit agreement maturing in April 2022.

Commercial Paper. Under our commercial paper program, we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker-dealers at any time not to exceed an aggregate amount of $5.0 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. There was no commercial paper outstanding balance as of December 31, 2022.
Long-term debt
Debt Issuance and Redemption. The Company did not enter into any debt issuances or redemptions in 2022. During 2021, in order to decrease future interest expense, mitigate future refinancing risk and raise proceeds for general corporate purposes, the Company entered into the following transactions:
Debt issuance: On March 3, 2021, the Company issued $4.3 billion of new senior notes. The proceeds of this issuance were mainly used to redeem outstanding debt securities. The remaining proceeds were used primarily for general corporate purposes.

Debt redemption: During 2021, the Company completed the redemption of a total of $4.5 billion in aggregate principal amount of certain of its outstanding debt securities. The Company recorded a pre-tax loss of $141 million ($110 million after-tax), consisting primarily of premium payments.
Debt Covenants. The Company was in compliance with its debt covenants as of December 31, 2022.
Debt Maturities. Maturities of outstanding long-term debt as of December 31, 2022 are as follows:
(In millions)
Scheduled Maturities (1)
2023$2,967 
2024$1,500 
2025$3,100 
2026$2,300 
2027$2,359 
Maturities after 2027$19,122 
(1) Long-term debt maturity amounts include current maturities of long-term debt. Finance leases are excluded from this table. See Note 20 - Leases for finance lease maturity amounts.    
Interest Expense
Interest expense on long-term and short-term debt was $1.3 billion in 2022 and 2021 and $1.4 billion in 2020.
v3.22.4
Common and Preferred Stock
12 Months Ended
Dec. 31, 2022
Equity [Abstract]  
Common and Preferred Stock Note 8 – Common and Preferred Stock
The Cigna Group has a total of 25 million shares of $1 par value preferred stock authorized for issuance. No shares of preferred stock were outstanding at December 31, 2022, 2021 or 2020.
The following table presents the share activity of The Cigna Group:
For the Years Ended December 31,
(Shares in thousands)202220212020
Common: Par value $0.01; 600,000 shares authorized
Outstanding- January 1,322,948 354,771 372,531 
Net issued for stock option exercises and other benefit plans3,173 3,375 4,142 
Repurchased common stock(27,445)(35,198)(21,902)
Outstanding- December 31,298,676 322,948 354,771 
Treasury stock99,143 71,246 35,505 
Issued- December 31,397,819 394,194 390,276 
Dividends
In 2022, The Cigna Group declared quarterly cash dividends of $1.12 per share of the Company's common stock. In 2021, The Cigna Group initiated and declared quarterly cash dividends of $1.00 per share of the Company's common stock.
The following table provides details of the Company's dividend payments:
Record DatePayment DateAmount per Share
Total Amount Paid (in millions)
2022
March 9, 2022March 24, 2022$1.12$357
June 8, 2022June 23, 2022$1.12$352
September 7, 2022September 22, 2022$1.12$341
December 6, 2022December 21, 2022$1.12$334
2021
March 10, 2021March 25, 2021$1.00$345
June 8, 2021June 23, 2021$1.00$342
September 8, 2021September 23, 2021$1.00$330
December 7, 2021December 22, 2021$1.00$324
2020
March 10, 2020April 9, 2020$0.04$15
On February 2, 2023, the Board of Directors declared the first quarter cash dividend of $1.23 per share of The Cigna Group common stock to be paid on March 23, 2023 to shareholders of record on March 8, 2023. The Company 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 of The 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 may deem relevant.
Accelerated Share Repurchase Agreements
In June 2022, as part of our existing share repurchase program, we entered into separate accelerated share repurchase agreements ("2022 ASR agreements") with Mizuho Markets Americas LLC and Morgan Stanley & Co. LLC (collectively, the "2022 Counterparties") to repurchase $3.5 billion of common stock in aggregate. In July 2022, we remitted $3.5 billion to the 2022 Counterparties and received an initial delivery of 10.4 million shares of our common stock representing $2.8 billion of the total remitted. Upon final settlement of the 2022 ASR agreements in November 2022, we received an additional 1.9 million shares of our common stock for no additional consideration as the value of this stock was held back by the 2022 Counterparties pending final settlement of the agreements. The total number of shares of our common stock repurchased under the 2022 ASR agreements was 12.3 million based on an average daily Volume-Weighted Average Share Price ("VWAP") of our common stock over the term of the agreements, less a discount, of $285.10 per share.
In August 2021, as part of our existing share repurchase program, we entered into separate accelerated share repurchase agreements ("2021 ASR agreements") with Morgan Stanley & Co. LLC and JP Morgan Chase Bank, N.A. (collectively, the "2021 Counterparties") to repurchase $2.0 billion of common stock in aggregate. We remitted $2.0 billion to the 2021 Counterparties and received an initial delivery of 7.7 million shares of our common stock representing $1.6 billion of the total remitted. Upon final settlement of the 2021 ASR agreements in fourth quarter of 2021, we received an additional 1.8 million shares of our common stock for no additional consideration as the value of this stock was held back by the 2021 Counterparties pending final settlement of the agreements. The total number of shares of our common stock repurchased under the 2021 ASR agreements was 9.5 million based on an average daily VWAP of our common stock over the term of the agreements, less a discount, of $209.53 per share.
v3.22.4
Insurance and Contractholder Liabilities
12 Months Ended
Dec. 31, 2022
Insurance Loss Reserves [Abstract]  
Insurance and Contractholder Liabilities
Note 9 – Insurance and Contractholder Liabilities
A.Account Balances – Insurance and Contractholder Liabilities
The Company's insurance and contractholder liabilities were comprised of the following:
December 31, 2022December 31, 2021
(In millions)CurrentNon-currentTotalCurrentNon-currentTotal
Contractholder deposit funds$365 $6,515 $6,880 $352 $6,702 $7,054 
Future policy benefits229 4,708 4,937 312 9,194 9,506 
Unearned premiums576 22 598 558 418 976 
Unpaid claims and claim expenses
Cigna Healthcare
4,117 59 4,176 4,159 102 4,261 
Other Operations98 177 275 548 180 728 
Total5,929 16,596 22,525 
Insurance and contractholder liabilities classified as Liabilities of businesses held for sale (1)
(611)(4,033)(4,644)
Total insurance and contractholder liabilities per Consolidated Balance Sheets$5,385 $11,481 $16,866 $5,318 $12,563 $17,881 
(1) Amounts classified as Liabilities of businesses held for sale primarily include $3.8 billion of Future policy benefits, $0.4 billion of Unpaid claims and $0.4 billion of Unearned premiums as of December 31, 2021.
Insurance and contractholder liabilities expected to be paid within one year are classified as current.
Accounting policy - Contractholder Deposit Funds. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products and investment earnings on their fund balances. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. In addition, this caption includes: 1) premium stabilization reserves under group health insurance contracts representing experience refunds left with the Company to pay future premiums; 2) deposit administration funds used to fund non-pension retiree insurance programs; 3) retained asset accounts and 4) annuities or supplementary contracts without significant life contingencies. Interest credited on these funds is accrued ratably over the contract period. Accounting policy - Future Policy Benefits. Future policy benefits represent the present value of estimated future obligations under long-term life and supplemental health insurance policies and annuity products currently in force. These obligations are estimated using actuarial methods and consist primarily of reserves for annuity contracts, life insurance benefits, GMDB contracts (GMDB
contracts are fully reinsured, see Note 10 for additional information) and certain life and accident insurance products of our sold international businesses.
Obligations for annuities represent specified periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Obligations for life insurance policies and GMDB contracts represent benefits expected to be paid to policyholders, net of future premiums expected to be received. Management estimates these obligations based on assumptions as to premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders, allowing for adverse deviation as appropriate. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables. Interest rate assumptions are based on management's judgment considering the Company's experience and future expectations and range from 2% to 9%. Obligations for the direct and assumed run-off settlement annuity business include adjustments for realized and unrealized investment returns consistent with GAAP when a premium deficiency exists. As of December 31, 2022, approximately 24% of the liability for future policy benefits was supported by assets held in trust for the benefit of the ceding company under reinsurance agreements.
Accounting policy - Unearned Premium. The unrecognized portion of premiums received is recorded as unearned premiums included in Insurance and contractholder liabilities (current and non-current). Unpaid Claims and Claim Expenses – Cigna HealthcareThis liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.
Accounting policy. The Company uses actuarial principles and assumptions that are consistently applied each reporting period and recognizes the actuarial best estimate of the ultimate liability along with a margin for adverse deviation. This approach is consistent with actuarial standards of practice that the liabilities be adequate under moderately adverse conditions.
The Company compares key assumptions used to establish the medical costs payable to actual experience for each reporting period. The unpaid claims liability is adjusted through current period shareholders' net income when actual experience differs from these assumptions. Additionally, the Company evaluates expected future developments and emerging trends that may impact key assumptions. The process used to determine this liability requires the Company to make critical accounting estimates that involve considerable judgment, reflecting the variability inherent in forecasting future claim payments. These estimates are highly sensitive to changes in the Company's key assumptions, specifically completion factors and medical cost trend.
The liability is primarily calculated using "completion factors" developed by comparing the claim incurral date to the date claims were paid. Completion factors are impacted by several key items including changes in: 1) electronic (auto-adjudication) versus manual claim processing; 2) frequency and timeliness of provider claims submissions; 3) number of customers and 4) the mix of products. The Company uses historical completion factors combined with an analysis of current trends and operational factors to develop current estimates of completion factors. The Company estimates the liability for claims incurred in each month by applying the current estimates of completion factors to the current paid claims data. This approach implicitly assumes that historical completion rates will be a useful indicator for the current period.
The Company relies more heavily on medical cost trend analysis that reflects expected claim payment patterns and other relevant operational considerations for more recent months. Medical cost trend is primarily impacted by medical service utilization and unit costs that are affected by changes in the level and mix of health benefits offered, including inpatient, outpatient and pharmacy, the impact of copays and deductibles, changes in provider practices and changes in consumer demographics and consumption behavior.
The total of incurred but not reported liabilities plus expected development on reported claims, including reported claims in process, was $3.9 billion at December 31, 2022 and $4.0 billion at December 31, 2021.
Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows:
For the Years Ended December 31,
(In millions)202220212020
Beginning balance$4,261 $3,695 $3,336 
Less: Reinsurance and other amounts recoverable261 237 318 
Beginning balance, net4,000 3,458 3,018 
Incurred costs related to:
Current year31,342 31,755 27,494 
Prior years(259)(219)(144)
Total incurred31,083 31,536 27,350 
Paid costs related to:
Current year27,583 27,929 24,187 
Prior years3,545 3,065 2,723 
Total paid31,128 30,994 26,910 
Ending balance, net3,955 4,000 3,458 
Add: Reinsurance and other amounts recoverable221 261 237 
Ending balance$4,176 $4,261 $3,695 
Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 for additional information on reinsurance.
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
For the Years Ended December 31,
20222021
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors$62 0.2 %$81 0.3 %
Medical cost trend197 0.6 138 0.5 
Total favorable variance$259 0.8 %$219 0.8 %
(1) Percentage of current year incurred costs as reported for the year ended December 31, 2021.
(2) Percentage of current year incurred costs as reported for the year ended December 31, 2020.

Favorable prior year development in both years reflects lower than expected utilization of medical services as compared to our assumptions.
The following table depicts the incurred and paid claims development and unpaid claims liability as of December 31, 2022 (net of reinsurance) reported in the Cigna Healthcare segment. The information about incurred and paid claims development for the year ended December 31, 2021 is presented as supplementary information and is unaudited.
 Incurred Costs 
Incurral Year2021
(Unaudited)
2022Unpaid Claims & Claim Expenses
(In millions)  
2021$30,735 $30,493 180 
202230,309 3,622 
Cumulative incurred costs for the periods presented$60,802  
 Cumulative Costs Paid 
Incurral Year2021
(Unaudited)
2022 
(In millions)
2021$27,039 $30,313  
202226,687  
Cumulative paid costs for the periods presented$57,000  
Outstanding liabilities for the periods presented, net of reinsurance$3,802  
Other long-duration liabilities not included in development table above153  
Net unpaid claims and claims expenses - Cigna Healthcare
3,955  
Reinsurance and other amounts recoverable221  
Unpaid claims and claim expenses - Cigna Healthcare
$4,176  
Incurred claims do not typically remain outstanding for multiple years; more than 95% of health claims incurred in a year are paid by the end of the following year.
There is no single or common claim frequency metric used in the health care industry. The Company believes a relevant metric for its health insurance business is the number of customers for whom an insured medical claim was paid. Customers for whom no insured medical claim was paid are excluded from the calculation. Claims that did not result in a liability are not included in the frequency metric. The claim frequency for 2022 and 2021 was approximately 5 million.
Unpaid Claims and Claim Expenses – Other Operations
Accounting policy. Liabilities for unpaid claims and claim expenses are established by book of business within Other Operations including the liabilities divested in the Chubb transaction and divested through the sale of our ownership interest in a joint venture in Türkiye ("divested International businesses"). Unpaid claims and claim expenses within Other Operations consist of (1) case or claims reserves for reported claims that are unpaid as of the balance sheet date; (2) incurred but not reported reserves for claims when the insured event has occurred but has not been reported to the Company and (3) loss adjustment expense reserves for the expected costs of settling these claims. The Company consistently estimates incurred but not yet reported losses using actuarial principles and assumptions based on historical and projected claim incidence patterns, claim size and the expected payment period. The Company recognizes the actuarial best estimate of the ultimate liability within a level of confidence, consistent with actuarial standards of practice that the liabilities be adequate under moderately adverse conditions. The Company immediately records an adjustment in Medical costs and other benefit expenses when estimates of these liabilities change.
See Note 4 for a discussion of the divestiture of the Group Disability and Life business on December 31, 2020. Prior to the sale, the liabilities for unpaid claims and claim expenses in the Group Disability and Life business reflected reserves for long-term and short-term disability, life insurance and accident products. The majority of the unpaid claim liability related to disability claims that was measured as the present value of estimated future benefit payments, including expected development, for each reported claim that was receiving benefit payments over the expected disability period or pending a decision on eligibility for benefits.
Liability balance details. The liability details for unpaid claims and claim expenses are presented in the following table.
(In millions)December 31, 2022December 31, 2021
Other Operations
Divested International businesses
$ $447 
Other Operations275 281 
Unpaid claims and claim expenses - Other Operations
$275 $728 
Activity in the unpaid claims and claim expenses for the divested International and Group Disability and Life business is presented in the following table. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been largely reinsured.
For the Years Ended December 31,
(In millions)
2022 (1)
2021
2020
Beginning balance$447 $452 $5,372 
Less: Reinsurance46 45 169 
Beginning balance, net401 407 5,203 
Incurred claims related to:
Current year507 982 4,205 
Prior years:
Interest accretion — 154 
All other incurred3 11 48 
Total incurred510 993 4,407 
Paid claims related to:
Current year322 738 2,392 
Prior years187 227 1,690 
Total paid509 965 4,082 
Foreign currency(28)(34)21 
Divestiture of businesses(2)
(374)— (5,142)
Ending balance, net 401 407 
Add: Reinsurance 46 45 
Ending balance
$ $447 $452 
(1) Beginning balance includes unpaid claims amounts classified as Liabilities of businesses held for sale.
(2) 2020 amounts include Group Disability and Life reserves sold or reinsured to New York Life Insurance Company as part of the sale of the Group Disability and Life business and immaterial retained balances which are now excluded from this table.

Reinsurance in the table above reflects amounts due from reinsurers related to unpaid claims liabilities. See Note 10 for additional information on reinsurance.
v3.22.4
Reinsurance
12 Months Ended
Dec. 31, 2022
Reinsurance Disclosures [Abstract]  
Reinsurance
Note 10 – Reinsurance
The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.
Reinsurance RecoverablesAccounting policy. Reinsurance recoverables represent amounts due from reinsurers for both paid and unpaid claims of the Company's insurance businesses. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. Most reinsurance recoverables are classified as non-current assets. The current portion of reinsurance recoverables is reported in Other current assets and consists primarily of recoverables on paid claims expected to be settled within one year. Reinsurance recoverables are presented net of allowances, consisting primarily of an allowance for expected credit losses which is recognized on reinsurance recoverable balances each period and adjusted through Medical costs and other benefit expenses. Estimates of the allowance for expected credit losses are based on internal and external data used to develop expected loss rates over the anticipated duration of the recoverable asset that vary by external credit rating and collateral level. The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables.
The Company's reinsurance recoverables as of December 31, 2022 are presented in the following table by range of external credit rating and collateral level:
(In millions)
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Collateral provisions exist that may mitigate risk of credit loss (3)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (1)
$ $ $87 $87 
BBB- to BBB+ equivalent current credit ratings (1)
  58 58 
Not rated139 4 43 186 
Total recoverables related to ongoing operations (2)
139 4 188 331 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York 2,795  2,795 
Berkshire Hathaway Life Insurance Company of Nebraska248 432  680 
Empower Annuity Insurance Company  133 133 
Prudential Insurance Company of America375  — 375 
Life Insurance Company of North America— 387 — 387 
Other203 19 16 238 
Not rated 12 3 15 
Total recoverables related to acquisition, disposition or run-off activities826 3,645 152 4,623 
Total$965 $3,649 $340 $4,954 
Allowance for uncollectible reinsurance(37)
Total reinsurance recoverables (2)
$4,917 
(1) Certified by a Nationally Recognized Statistical Rating Organization ("NRSRO").
(2) Includes $174 million of current reinsurance recoverables that are reported in Other current assets.
(3) Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value.
Effects of ReinsuranceThe following table presents direct, assumed and ceded premiums for both short-duration and long-duration insurance contracts. It also presents reinsurance recoveries that have been netted against Medical costs and other benefit expenses in the Company's Consolidated Statements of Income.
For the Years Ended December 31,
(In millions)202220212020
Premiums
Short-duration contracts
Direct$36,746 $36,513 $38,425 
Assumed416 335 85 
Ceded(265)(148)(230)
Total short-duration contract premiums36,897 36,700 38,280 
Long-duration contracts
Direct3,219 4,753 4,517 
Assumed85 99 99 
Ceded(286)(398)(269)
Total long-duration contract premiums3,018 4,454 4,347 
Total premiums$39,915 $41,154 $42,627 
Total reinsurance recoveries$702 $552 $431 
Effective Exit of GMDB and GMIB BusinessThe Company entered into an agreement with Berkshire to effectively exit the GMDB and GMIB business via a reinsurance transaction in 2013. Berkshire reinsured 100% of the Company's future claim payments in this business, net of other reinsurance arrangements existing at that time. The reinsurance agreement is subject to an overall limit with approximately $3.1 billion remaining at December 31, 2022.GMDB is accounted for as assumed and ceded reinsurance and GMIB assets and liabilities are reported as derivatives at fair value as discussed below. GMIB assets are reported in Other current assets and Other assets and GMIB liabilities are reported in Accrued expenses and other liabilities and Other non-current liabilities.
GMDB
The GMDB exposure arises under annuities written by ceding companies that guarantee the benefit received at death. The Company's exposure arises when the guaranteed minimum death benefit exceeds the fair value of the related mutual fund investments at the time of a contractholder's death.
Accounting policy. The Company estimates the gross liability and reinsurance recoverable with an internal model based on the Company's experience and future expectations over an extended period, consistent with the long-term nature of this product. As a result of the reinsurance transaction, reserve increases have a corresponding increase in the recorded reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit (including the GMIB asset presented below).
The following table presents the account value, net amount at risk and the number of contractholders for guarantees assumed by the Company in the event of death. The net amount at risk is the amount that the Company would have to pay if all contractholders died as of the specified date. As of December 31, 2022, the account value decreased primarily due to unfavorable equity market performance, which resulted in an increase to the net amount at risk. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded.
(Dollars in millions, excludes impact of reinsurance ceded)December 31, 2022December 31, 2021
Account value$7,436 $9,795 
Net amount at risk$2,114 $1,392 
Average attained age of contractholders (weighted by exposure)7577
Number of contractholders (estimated)150,000 170,000 
GMIB
The Company reinsured contracts with issuers of GMIB products. The Company's exposure represents the excess of a contractually guaranteed amount over the level of variable annuity account values. Payment by the Company depends on the actual account value in the related underlying mutual funds and the level of interest rates when the contractholders elect to receive minimum income payments that can only occur within 30 days of a policy anniversary after the appropriate waiting period. The Company has purchased retrocessional coverage ("GMIB assets") for these contracts including retrocessional coverage from Berkshire.
Accounting policy. The Company reports GMIB liabilities and assets as derivatives at fair value because cash flows of these liabilities and assets are affected by equity markets and interest rates, but are without significant life insurance risk and are settled in lump sum payments. The Company receives and pays fees periodically based on either contractholders' account values or deposits increased at a contractual rate. The Company will also pay and receive cash depending on changes in account values and interest rates when contractholders first elect to receive minimum income payments.
Assumptions used in fair value measurement. GMIB assets and liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates). The Company classifies GMIB assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 because assumptions related to future annuitant behavior are largely unobservable.
The only assumption expected to impact future shareholders' net income is non-performance risk. The non-performance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the GMIB liabilities to be paid by the Company and (b) the GMIB assets to be paid by the reinsurers, after considering collateral. The impact of non-performance risk was immaterial for the years ended December 31, 2022 and December 31, 2021.
GMIB liabilities totaled $404 million as of December 31, 2022 and $572 million as of December 31, 2021. The GMIB liabilities reflect the Company's credit risk, while the reinsurance recoverable reflects the credit risk of the reinsurers. There were three reinsurers covering 100% of the GMIB exposures as of December 31, 2022 and December 31, 2021 as follows:
(In millions)
Line of BusinessReinsurerDecember 31, 2022December 31, 2021
Collateral and Other Terms at December 31, 2022
GMIBBerkshire$203 $283 
100% were secured by assets in a trust.
Sun Life Assurance Company of Canada119 167 
Liberty Re (Bermuda) Ltd.108 151 
100% were secured by assets in a trust.
Total GMIB recoverables reported in Other current assets and Other assets
$430 $601 
All reinsurers are rated A- equivalent and higher by an NRSRO.
v3.22.4
Investments
12 Months Ended
Dec. 31, 2022
Investments [Abstract]  
Investments Note 11 – Investments
The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 for information about the valuation of the Company's investment portfolio.

Debt securities, commercial mortgage loans, derivative financial instruments and short-term investments with contractual maturities during the next twelve months are classified on the balance sheet as current investments, unless they are held as statutory deposits or restricted for other purposes and then they are classified in Long-term investments. Equity securities may include funds that are used in our cash management strategy and are classified as current investments. All other investments are classified as Long-term investments.
The following table summarizes the Company's investments by category and current or long-term classification:
December 31, 2022December 31, 2021
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$654 $9,218 $9,872 $796 $16,162 $16,958 
Equity securities45 577 622 — 603 603 
Commercial mortgage loans67 1,547 1,614 40 1,526 1,566 
Policy loans 1,218 1,218 — 1,338 1,338 
Other long-term investments 3,728 3,728 — 3,574 3,574 
Short-term investments139  139 428 — 428 
Total1,264 23,203 24,467 
Investments classified as Assets of businesses held for sale (1)
(344)(4,765)(5,109)
Investments per Consolidated Balance Sheets$905 $16,288 $17,193 $920 $18,438 $19,358 
(1) Investments related to the divested International businesses that were held for sale as of December 31, 2021. These investments were primarily comprised of debt securities and other long-term investments, and to a lesser extent, equity securities and short-term investments. See Note 4 for additional information.
Investment PortfolioDebt Securities
Accounting policy. Debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) are classified as available for sale and are carried at fair value with changes in fair value recorded either in Accumulated other comprehensive loss within Shareholders' equity or in credit loss expense based on fluctuations in the allowance for credit losses, as further discussed below. Net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive loss. When the Company intends to sell or determines that it is more likely than not to be required to sell an impaired debt security, the excess of amortized cost over fair value is directly written down with a charge to Net realized investment (losses) gains. Certain asset-backed securities are considered variable interest entities. See Note 13 for additional information.
The Company reviews declines in fair value from a debt security's amortized cost basis to determine whether a credit loss exists, and when appropriate, recognizes a credit loss allowance with a corresponding charge to credit loss expense, presented in Net realized investment (losses) gains in the Company's Consolidated Statements of Income. The allowance for credit loss represents the excess of amortized cost over the greater of its fair value or the net present value of the debt security's projected future cash flows (based on qualitative and quantitative factors, including the probability of default and the estimated timing and amount of recovery). Each period, the allowance for credit loss is adjusted as needed through credit loss expense.
The Company does not measure an allowance for credit losses for accrued interest receivables. When interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured, accrued interest, reported in Other current assets, is written off through a charge to Net investment income and interest income is recognized on a cash basis.
The amortized cost and fair value by contractual maturity periods for debt securities were as follows:
December 31, 2022
(In millions)Amortized
Cost
Fair
Value
Due in one year or less$681 $674 
Due after one year through five years3,817 3,583 
Due after five years through ten years3,457 3,052 
Due after ten years2,497 2,215 
Mortgage and other asset-backed securities390 348 
Total$10,842 $9,872 
Actual maturities of these securities could differ from their contractual maturities used in the table above because issuers may have the right to call or prepay obligations, with or without penalties.
Our allowance for credit losses on debt securities was not material as of December 31, 2022 and December 31, 2021. Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below:
(In millions)Amortized
Cost
Allowance for Credit LossUnrealized
Appreciation
Unrealized
Depreciation
Fair
Value
December 31, 2022
Federal government and agency$292 $ $32 $(12)$312 
State and local government43   (2)41 
Foreign government375  11 (21)365 
Corporate9,742 (44)89 (981)8,806 
Mortgage and other asset-backed390  1 (43)348 
Total$10,842 $(44)$133 $(1,059)$9,872 
December 31, 2021
Federal government and agency$287 $— $101 $(1)$387 
State and local government154 — 17 — 171 
Foreign government2,468 — 194 (46)2,616 
Corporate12,361 (23)1,008 (80)13,266 
Mortgage and other asset-backed505 — 17 (4)518 
Total$15,775 $(23)$1,337 $(131)$16,958 
Investments supporting liabilities of the Company's run-off settlement annuity business (included in total above) (1)
$2,262 $(5)$720 $(10)$2,967 
(1) Net unrealized appreciation for these investments is excluded from Accumulated other comprehensive loss. As of December 31, 2022, net unrealized depreciation for these investments is included in Accumulated other comprehensive loss.
Review of declines in fair value. Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include:
severity of decline;
financial health and specific prospects of the issuer; and
changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.
The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased.
December 31, 2022December 31, 2021
(Dollars in millions)Fair
Value
Amortized
Cost
Unrealized
Depreciation
Number
of Issues
Fair
Value
Amortized
Cost
Unrealized
Depreciation
Number
of Issues
One year or less
Investment grade$5,533 $6,127 $(594)1,659$2,785 $2,861 $(76)909 
Below investment grade887 964 (77)1,287561 578 (17)781 
More than one year
Investment grade1,151 1,487 (336)462382 412 (30)143 
Below investment grade330 382 (52)369162 170 (8)53 
Total$7,901 $8,960 $(1,059)3,777 $3,890 $4,021 $(131)1,886 
Equity Securities
Accounting policy. Equity securities with a readily determinable fair value consist primarily of public equity investments in the health care sector and mutual funds that invest in fixed income debt securities while those without a readily determinable fair value consist of private equity investments. Changes in the fair values of equity securities that have a readily determinable fair value are reported in Net realized investment (losses) gains. Equity securities without a readily determinable fair value are carried at cost minus impairment, if any, plus or minus changes resulting from observable price changes.
The following table provides the values of the Company's equity security investments. The amount of impairments or value changes resulting from observable price changes on equity securities with no readily determinable fair value still held was not material to the financial statements as of December 31, 2022 or 2021.
December 31, 2022 December 31, 2021
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$673 $138 $257 $207 
Equity securities with no readily determinable fair value380 484 270 396 
Total$1,053 $622 $527 $603 
As of December 31, 2022, the Company had a commitment to purchase up to $2.7 billion of preferred equity in VillageMD. We funded $2.5 billion of this commitment during January 2023. Approximately 70% of our investments in equity securities as of December 31, 2022 are in the health care sector, consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry.
Commercial Mortgage Loans
Accounting policy. Commercial mortgage loans are carried at unpaid principal balances, net of an allowance for expected credit losses, and classified as either current or long-term investments based on their contractual maturities. Changes in the allowance for expected credit losses are recognized as credit loss expense and presented in Net realized investment (losses) gains in the Company's Consolidated Statements of Income.
Each period, the Company establishes (or adjusts) its allowance for expected credit losses for commercial mortgage loans. The allowance for expected credit losses is based on a credit risk category that is assigned to each loan at origination using key credit quality indicators, including debt service coverage and loan-to-value ratios. Credit risk categories are updated as key credit quality indicators change. An expected loss rate, assigned based on the credit risk category, is applied to each loan's unpaid principal balance to develop the aggregate allowance for expected credit losses. Commercial mortgage loans are considered impaired and written off against the allowance when it is probable that the Company will not collect all amounts due per the terms of the promissory note. In the event of a foreclosure, the allowance for credit losses is based on the excess of the carrying value of the mortgage loan over the fair value of its underlying collateral.
Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties.
Credit quality. The Company regularly evaluates and monitors credit risk, beginning with the initial underwriting of a mortgage loan and continuing throughout the investment holding period. Mortgage origination professionals employ an internal credit quality rating system designed to evaluate the relative risk of the transaction at origination that is then updated each year as part of the annual portfolio loan review. The Company evaluates and monitors credit quality on a consistent and ongoing basis.
Quality ratings are based on our evaluation of a number of key inputs related to the loan, including real estate market-related factors such as rental rates and vacancies, and property-specific inputs such as growth rate assumptions and lease rollover statistics. However, the two most significant contributors to the credit quality rating are the debt service coverage and loan-to-value ratios. The debt service coverage ratio measures the amount of property cash flow available to meet annual interest and principal payments on debt, with a ratio below 1.0 indicating that there is not enough cash flow to cover the required loan payments. The loan-to-value ratio, commonly expressed as a percentage, compares the amount of the loan to the fair value of the underlying property collateralizing the loan.
The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:
(Dollars in millions)December 31, 2022December 31, 2021
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$901 2.12$560 2.18
60% to 79%564 1.73883 1.89
80% to 100%149 1.17123 1.47
Total$1,614 1.8960 %$1,566 1.9661 %
Policy Loans
Accounting policy. Policy loans, primarily associated with our corporate-owned life insurance business, are carried at unpaid principal balances plus accumulated interest, the total of which approximates fair value. These loans are collateralized by life insurance policy cash values and therefore have minimal exposure to credit loss. Interest rates are reset annually based on a rolling average of benchmark interest rates.
Other Long-term Investments
Accounting policy. Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans and health care-related investments. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.
Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Depreciation is generally recorded using the straight-line method based on the estimated useful life of each asset. Investment real estate as of December 31, 2022 and 2021 is expected to be held longer than one year and may include real estate acquired through the foreclosure of commercial mortgage loans.
Additionally, foreign currency swaps carried at fair value as well as statutory and other restricted deposits are reported in the table below as "Other." See discussion below for information on the Company's accounting policies for derivative financial instruments.
Other long-term investments and related commitments are diversified by issuer, property type and geographic regions. These investments are primarily unconsolidated variable interest entities (see Note 13 for additional information). The following table provides unfunded commitment and carrying value information for these investments. The Company expects to disburse approximately 30% of the committed amounts in 2023.

Our limited partnership investments are reduced as the Company receives cash distributions for returns on its investment that were previously recognized in Net investment income. The amount of these cash distributions was $487 million in 2022, $568 million in 2021 and $227 million in 2020.
Unfunded Commitments as of
Carrying Value as of December 31,
(In millions)20222021December 31, 2022
Real estate investments$1,319 $1,152 $668 
Securities partnerships2,166 2,272 1,704 
Other243 150  
Total$3,728 $3,574 $2,372 
Short-Term Investments and Cash Equivalents
Accounting policy. Security investments with maturities of greater than three months to one year from time of purchase are classified as short-term, available for sale and carried at fair value that approximates cost. Cash equivalents consist of short-term investments with maturities of three months or less from the time of purchase and are carried at cost that approximates fair value.
Derivative Financial InstrumentsThe Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt. The Company has written and purchased GMIB reinsurance contracts in its run-off reinsurance business that are accounted for as freestanding derivatives as discussed in Note 10. Derivatives in the Company's separate accounts are excluded from the following discussion because associated gains and losses generally accrue directly to separate account policyholders.Accounting policy. Derivatives are recorded in our Consolidated Balance Sheets at fair value and are classified as current or non-current according to their contractual maturities. Further information on our policies for determining fair value are discussed in Note 12. The Company applies hedge accounting when derivatives are designated, qualified and highly effective as hedges. Under hedge accounting, the changes in fair value of the derivative and the hedged risk are generally recognized together and offset each other
when reported in Shareholders' net income Various qualitative or quantitative methods appropriate for each hedge are used to formally assess and document hedge effectiveness at inception and each period throughout the life of a hedge.
The Company's derivative financial instruments are presented as follows: 
Fair value hedges of the foreign exchange-related changes in fair values of certain foreign-denominated bonds: Swap fair values are reported in Long-term investments or Other non-current liabilities. Offsetting changes in fair values attributable to the foreign exchange risk of the swap contracts and the hedged bonds are reported in Net realized investment (losses) gains. The portion of the swap contracts' changes in fair value excluded from the assessment of hedge effectiveness is recorded in Other comprehensive (loss) income and recognized in Net investment income as swap coupon payments are accrued, offsetting the foreign-denominated coupons received on the designated bonds. Net cash flows are reported in Operating activities, while exchanges of notional principal amounts are reported in Investing activities.
Fair value hedges of the interest rate exposure on the Company's long-term debt: Using fair value hedge accounting, the fair values of the swap contracts are reported in other assets or other liabilities. The critical terms of these swaps match those of the long-term debt being hedged. As a result, the carrying value of the hedged debt is adjusted to reflect changes in its fair value driven by the Secured Overnight Financing Rate ("SOFR"). The effects of those adjustments on interest expense are offset by the effects of corresponding changes in the swaps' fair value. The net impact from the hedge reported in Interest expense and other reflects interest expense on the hedged debt at the variable interest rate. Cash flows relating to these contracts are reported in Operating activities.
Net investment hedges of certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. dollar: The fair values of the foreign currency swap and forward contracts are reported in other assets or other liabilities. The changes in fair values of these instruments are reported in Other comprehensive (loss) income, specifically in translation of foreign currencies. The portion of the change in fair values relating to foreign exchange spot rates will be recognized in earnings upon deconsolidation of the hedged foreign subsidiaries. The remaining changes in fair value of these instruments are excluded from our effectiveness assessment and recognized in Interest expense and other over the term of the instrument. Cash flows relating to these contracts are reported in Investing activities.
Economic hedges for derivatives not designated as accounting hedges: Fair values of forward contracts are reported in Investments (current) or Accrued expenses and other liabilities. The changes in fair values are reported in Net realized investment (losses) gains. Cash flows relating to these contracts are reported in Investing activities.
The gross fair values of our derivative financial instruments are presented in Note 12. Although we may incur a loss if dealers failed to perform under derivative contracts, collateral has been posted to cover substantially all of the net fair value owed to the Company. As of December 31, 2022 and December 31, 2021, the effects of derivative financial instruments used in these individual hedging strategies were not material to the Consolidated Financial Statements. The following table summarizes the types and notional quantity of derivative instruments held by the Company:
Notional Value as of
(In millions)December 31, 2022December 31, 2021
PurposeType of Instrument
Fair value hedge: To hedge the foreign exchange-related changes in fair values of certain foreign-denominated bonds. The notional value of these derivatives matches the amortized cost of the hedged bonds. A majority of these instruments are denominated in Euros, with the remaining instruments denominated in British Pounds Sterling and Australian Dollars.
Foreign currency swap contracts
$1,083 $1,081 
Fair value hedge: To convert a portion of the interest rate exposure on the Company's long-term debt from fixed to variable rates. This more closely aligns the Company's interest expense with the interest income received on its cash equivalent and short-term investment balances. The variable rates are benchmarked to SOFR.
Interest rate swap contracts$1,500 $750 
Net investment hedge: To reduce the risk of changes in net assets due to changes in foreign currency spot exchange rates for certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Foreign currency swap contracts are denominated in Euros.
Foreign currency swap contracts
$460 $526 

Foreign currency forward contracts used in net investment hedge and economic hedge strategies with notional values of approximately $1.4 billion and $0.7 billion as of December 31, 2021, respectively, were associated with the International businesses divested to Chubb during 2022. See Note 4 to the Consolidated Financial Statements for further information.
Concentration of Risk
The Company did not have a concentration of investments in a single issuer or borrower exceeding 10% of shareholders' equity as of December 31, 2022 or 2021.
Net Investment Income
Accounting policy. When interest and principal payments on investments are current, the Company recognizes interest income when it is earned. The Company recognizes interest income on a cash basis when interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured. For unconsolidated entities that are included in other long-term investments investment income is generally recognized according to the Company's share of the reported income or loss on the underlying investments. Investment income attributed to the Company's separate accounts is excluded from our earnings because associated gains and losses generally accrue directly to separate account policyholders.
The components of Net investment income were as follows:
For the Years Ended December 31,
(In millions)202220212020
Debt Securities$572 $689 $962 
Equity securities14 12 11 
Commercial mortgage loans59 60 80 
Policy loans59 63 64 
Other long-term investments390 758 127 
Short-term investments and cash115 26 52 
Total investment income1,209 1,608 1,296 
Less investment expenses54 59 52 
Net investment income$1,155 $1,549 $1,244 
Realized Investment Gains and LossesAccounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities and changes in allowances for credit losses on debt securities and commercial mortgage loan investments.
The following realized gains and losses on investments exclude amounts required to adjust future policy benefits for the run-off settlement annuity business (consistent with accounting for a premium deficiency), as well as realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders:
For the Years Ended December 31,
(In millions)202220212020
Net realized investment (losses) gains, excluding credit loss expense and asset write-downs
$(459)$194 $186 
Credit loss (expense) recoveries
(36)(27)
Other investment asset write-downs — (10)
Net realized investment (losses) gains, before income taxes
$(495)$196 $149 
Net realized investment losses for the year ended December 31, 2022 were primarily due to mark-to-market losses on a strategic health care equity securities investment.
v3.22.4
Fair Value Measurements
12 Months Ended
Dec. 31, 2022
Fair Value Disclosures [Abstract]  
Fair Value Measurements
Note 12 – Fair Value Measurements
The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.
Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.
The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's
fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).
The Company estimates fair values using prices from third parties or internal pricing methods. Fair value estimates received from third-party pricing services are based on reported trade activity and quoted market prices when available and other market information that a market participant would use to estimate fair value. The internal pricing methods are performed by the Company's investment professionals and generally involve using discounted cash flow analyses, incorporating current market inputs for similar financial instruments with comparable terms and credit quality as well as other qualitative factors. In instances where there is little or no market activity for the same or similar instruments, fair value is estimated using methods, models and assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. These valuation techniques involve some level of estimation and judgment that becomes significant with increasingly complex instruments or pricing models.
The Company is responsible for determining fair value and for assigning the appropriate level within the fair value hierarchy based on the significance of unobservable inputs. The Company reviews methodologies, processes and controls of third-party pricing services and compares prices on a test basis to those obtained from other external pricing sources or internal estimates. The Company performs ongoing analyses of both prices received from third-party pricing services and those developed internally to determine that they represent appropriate estimates of fair value. The controls executed by the Company include evaluating changes in prices and monitoring for potentially stale valuations. The Company also performs sample testing of sales values to confirm the accuracy of prior fair value estimates. The minimal exceptions identified during these processes indicate that adjustments to prices are infrequent and do not significantly impact valuations. An annual due-diligence review of the most significant pricing service is conducted to review their processes, methodologies and controls. This review includes a walk-through of inputs for a sample of securities held across various asset types to validate the documented pricing process.
Financial Assets and Financial Liabilities Carried at Fair Value
The following table provides information about the Company's financial assets and liabilities carried at fair value. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders:
(In millions)Quoted Prices in Active Markets for Identical Assets
(Level 1)
Significant Other Observable Inputs
(Level 2)
Significant Unobservable Inputs
(Level 3)
Total
December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021
Financial assets at fair value
Debt securities
Federal government and agency$147 $147 $165 $240 $ $— $312 $387 
State and local government — 41 171  — 41 171 
Foreign government — 365 2,611  365 2,616 
Corporate
 — 8,394 12,606 412 660 8,806 13,266 
Mortgage and other asset-backed — 313 418 35 100 348 518 
Total debt securities147 147 9,278 16,046 447 765 9,872 16,958 
Equity securities (1)
6 16 132 160  31 138 207 
Short-term investments — 139 428  — 139 428 
Derivative assets — 230 143 1 — 231 143 
Financial liabilities at fair value
Derivative liabilities$ $— $ $33 $ $— $ $33 
(1) Excludes certain equity securities that have no readily determinable fair value.
Level 1 Financial Assets
Inputs for instruments classified in Level 1 include unadjusted quoted prices for identical assets in active markets accessible at the measurement date. Active markets provide pricing data for trades occurring at least weekly and include exchanges and dealer markets.
Assets in Level 1 include actively-traded U.S. government bonds and exchange-listed equity securities. A relatively small portion of the Company's investment assets are classified in this category given the narrow definition of Level 1 and the Company's investment asset strategy to maximize investment returns.
Level 2 Financial Assets and Financial Liabilities
Inputs for instruments classified in Level 2 include quoted prices for similar assets or liabilities in active markets, quoted prices from those willing to trade in markets that are not active or other inputs that are market observable or can be corroborated by market data for the term of the instrument. Such other inputs include market interest rates and volatilities, spreads and yield curves. An instrument is classified in Level 2 if the Company determines that unobservable inputs are insignificant.
Debt and equity securities. Approximately 94% of the Company's investments in debt and equity securities are classified in Level 2 including most public and private corporate debt and equity securities, federal agency and municipal bonds, non-government mortgage-backed securities and preferred stocks. Third-party pricing services and internal methods often use recent trades of securities with similar features and characteristics because many debt securities do not trade daily. Pricing models are used to determine these prices when recent trades are not available. These models calculate fair values by discounting future cash flows at estimated market interest rates. Such market rates are derived by calculating the appropriate spreads over comparable U.S. Treasury securities based on the credit quality, industry and structure of the asset. Typical inputs and assumptions to pricing models include, but are not limited to, a combination of benchmark yields, reported trades, issuer spreads, liquidity, benchmark securities, bids, offers, reference data and industry and economic events. For mortgage-backed securities, inputs and assumptions may also include characteristics of the issuer, collateral attributes, prepayment speeds and credit rating. Nearly all of these instruments are valued using recent trades or pricing models.
Short-term investments are carried at fair value that approximates cost. The Company compares market prices for these securities to recorded amounts on a regular basis to validate that current carrying amounts approximate exit prices. The short-term nature of the investments and corroboration of the reported amounts over the holding period support their classification in Level 2.
Derivative assets and liabilities classified in Level 2 represent over-the-counter instruments such as foreign currency forward and swap contracts. Fair values for these instruments are determined using market observable inputs including forward currency and interest rate curves and widely published market observable indices. Credit risk related to the counterparty and the Company is considered when estimating the fair values of these derivatives. However, the Company is largely protected by collateral arrangements with counterparties and determined that no adjustments for credit risk were required as of December 31, 2022 or December 31, 2021. The nature and use of these derivative financial instruments are described in Note 11.
Level 3 Financial Assets and Financial Liabilities
Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date.
The Company classifies certain newly-issued, privately-placed, complex or illiquid securities in Level 3. Approximately 5% of debt and equity securities are priced using significant unobservable inputs and classified in this category.
Fair values of mortgage and other asset-backed securities, as well as corporate and government debt securities, are primarily determined using pricing models that incorporate the specific characteristics of each asset and related assumptions including the investment type and structure, credit quality, industry and maturity date in comparison to current market indices, spreads and liquidity of assets with similar characteristics. Inputs and assumptions for pricing may also include characteristics of the issuer, collateral attributes and prepayment speeds for mortgage and other asset-backed securities. Recent trades in the subject security or similar securities are assessed when available, and the Company may also review published research in its evaluation, as well as the issuer's financial statements.
Quantitative Information about Unobservable Inputs
The significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security.

The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities. The range and weighted average basis point ("bps") amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values.
Fair Value as ofUnobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)December 31, 2022December 31, 2021Unobservable input December 31, 2022December 31, 2022December 31, 2021
Debt securities
Corporate and government debt securities$412 $664 Liquidity
60 - 1060 (265)
bps
60 - 1060 (410)
bps
Mortgage and other asset-backed securities35 100 Liquidity
105 - 520 (310)
bps
60 - 390 (100)
bps
Other debt securities 
Total Level 3 debt securities$447 $765 

A significant increase in liquidity spread adjustments would result in a lower fair value measurement, while a decrease would result in a higher fair value measurement.
Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value
The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.
For the Years Ended December 31,
(In millions)20222021
Debt and Equity Securities
Beginning balance$796 $854 
Gains (losses) included in Shareholders' net income
11 (22)
Losses included in Other comprehensive (loss) income
(59)(6)
Losses required to adjust future policy benefits for settlement annuities (1)
 (8)
Purchases, sales and settlements
Purchases158 138 
Sales (36)
Settlements(207)(119)
Total purchases, sales and settlements(49)(17)
Transfers into/(out of) Level 3
Transfers into Level 3124 207 
Transfers out of Level 3(376)(212)
Total transfers into/(out of) Level 3(252)(5)
Ending balance$447 $796 
Total losses included in Shareholders' net income attributable to instruments held at the reporting date
$(2)$(17)
Change in unrealized gain or (loss) included in Other comprehensive (loss) income for assets held at the end of the reporting period
$(60)$(10)
(1) Amounts do not accrue to shareholders.
Total gains and losses included in Shareholders' net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment (losses) gains and Net investment income.
Gains and losses included in Other comprehensive (loss) income, net of tax in the tables above are reflected in Net unrealized depreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.
Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market
activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 2022 and 2021 primarily reflected changes in liquidity estimates for certain private placement issuers across several sectors. See discussion under Quantitative Information about Unobservable Inputs above for more information.
Separate Accounts
Accounting policy. Separate account assets and liabilities are contractholder funds maintained in accounts with specific investment objectives. The assets of these accounts are legally segregated and are not subject to claims that arise out of any of the Company's other businesses. These separate account assets are carried at fair value with equal amounts recorded for related separate account liabilities. The investment income and fair value gains and losses of separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. Fees and charges earned for mortality risks, asset management or administrative services are reported in either Premiums or Fees and other revenues. Investments that are measured using the practical expedient of net asset value ("NAV") are excluded from the fair value hierarchy.
Fair values of Separate account assets were as follows:
Quoted Prices in Active Markets for Identical Assets
(Level 1)
Significant Other Observable Inputs
(Level 2)
Significant Unobservable Inputs
(Level 3)
Total
(In millions)December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021
Guaranteed separate accounts (See Note 23)
$203 $227 $382 $276 $ $— $585 $503 
Non-guaranteed separate accounts (1)
211 1,130 5,522 6,406 203 334 5,936 7,870 
Subtotal$414 $1,357 $5,904 $6,682 $203 $334 6,521 8,373 
Non-guaranteed separate accounts priced at NAV as a practical expedient (1)
757 842 
Total9,215 
Separate account assets of businesses classified as held for sale (2)
(878)
Separate account assets per Consolidated Balance Sheets$7,278 $8,337 
(1) Non-guaranteed separate accounts include $4.0 billion as of December 31, 2022 and $4.5 billion as of December 31, 2021 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of December 31, 2022 and $0.3 billion as of December 31, 2021.
(2) Investments related to the divested International businesses that were held for sale as of December 31, 2021. See Note 4 for additional information.
Separate account assets classified as Level 1 primarily include exchange-listed equity securities. Level 2 assets primarily include:
corporate and structured bonds valued using recent trades of similar securities or pricing models that discount future cash flows at estimated market interest rates as described above; and
actively-traded institutional and retail mutual fund investments.
Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Activity, including transfers into and out of Level 3, was not material for the years ended December 31, 2022 or 2021.
Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments. Substantially all of these assets support the Company's pension plans. The following table provides additional information on these investments:
Fair Value as ofUnfunded Commitment as of December 31, 2022Redemption Frequency
(if currently eligible)
Redemption Notice
Period
(In millions)December 31, 2022December 31, 2021
Securities partnerships$451 $513 $249 Not applicableNot applicable
Real estate funds302 325  Quarterly
30 - 90 days
Hedge funds4  Up to annually, varying by fund
30 - 90 days
Total$757 $842 $249 
As of December 31, 2022, the Company does not have plans to sell any of these assets at less than fair value. These investments are structured to satisfy longer-term investment objectives. Securities partnerships are contractually non-redeemable and the underlying investment assets are expected to be liquidated by the fund managers within ten years after inception.
Assets and Liabilities Measured at Fair Value under Certain Conditions
Some financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value.

For the years ended December 31, 2022 and 2021, impairments recognized requiring these assets to be measured at fair value were not material. Realized investment gains and losses from these observable price changes for the years ended December 31, 2022 and December 31, 2021 were not material.
Fair Value Disclosures for Financial Instruments Not Carried at Fair Value
The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:
Classification in Fair Value HierarchyDecember 31, 2022December 31, 2021
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,491 $1,614 $1,598 $1,566 
Long-term debt, including current maturities, excluding finance leasesLevel 2$28,653 $30,994 $35,621 $31,593 
v3.22.4
Variable Interest Entities
12 Months Ended
Dec. 31, 2022
Variable Interest Entities [Abstract]  
Variable Interest Entities Note 13 – Variable Interest Entities
When the Company becomes involved with a variable interest entity and when there is a change in the Company's involvement with an entity, the Company must determine if it is the primary beneficiary and must consolidate the entity. The Company is considered the primary beneficiary if it has the power to direct the entity's most significant economic activities and has the right to receive benefits or obligation to absorb losses that could be significant to the entity. The Company evaluates the following criteria:
the structure and purpose of the entity;
the risks and rewards created by and shared through the entity; and
the Company's ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity including its sponsors, equity holders, guarantors, creditors and servicers.
The Company determined it was not a primary beneficiary in any material variable interest entity as of December 31, 2022 or 2021.
The Company's involvement in variable interest entities for which it is not the primary beneficiary is described below.
Securities limited partnerships and real estate limited partnerships. The Company owns interests in securities limited partnerships and real estate limited partnerships that are defined as unconsolidated variable interest entities. These partnerships invest in the equity or mezzanine debt of privately-held companies and real estate properties. General partners unaffiliated with the Company control decisions that most significantly impact the partnership's operations and the limited partners do not have substantive kick-out or participating rights. The Company has invested in approximately 175 limited partnerships that have a carrying value of $2.7 billion as of December 31, 2022 reported in other long-term investments. We have commitments to contribute an additional $2.1 billion to these entities. The Company's maximum exposure to loss from these investments is $4.8 billion, calculated as the sum of our carrying value and the additional funding commitments. Our noncontrolling interest in each of these limited partnerships is generally less than 10% of the partnership ownership interests. See Note 11 for further information on the Company's accounting policy for other long-term investments.

The Company has guaranteed debt payments to mortgage lenders for certain real estate limited partnerships should potential environmental obligations arise. No liability has been incurred related to these guarantees, and the Company's maximum exposure to these guarantees was approximately $340 million as of December 31, 2022.

Other variable interest entities. The Company is involved in other types of variable interest entities, including certain asset-backed and corporate securities, real estate joint ventures that develop properties for residential and commercial use, independent physician associations ("IPAs") that provide care management services and international health care joint ventures. The Company's maximum exposure to loss is $0.6 billion from certain asset-backed and corporate securities and $0.6 billion from real estate joint ventures, which represents the sum of our carrying value and the additional funding commitments for these entities. The carrying values and maximum exposures for the remaining unconsolidated variable interest entities were not material as of December 31, 2022.
The Company has not provided, and does not intend to provide, financial support to any of the variable interest entities in excess of its maximum exposure. We perform ongoing qualitative analyses of our involvement with these variable interest entities to determine if consolidation is required.
v3.22.4
Collectively Significant Operating Unconsolidated Subsidiaries
12 Months Ended
Dec. 31, 2022
Equity Method Investments and Joint Ventures [Abstract]  
Collectively Significant Operating Unconsolidated Subsidiaries
Note 14 – Collectively Significant Operating Unconsolidated Subsidiaries
In addition to equity method investments, including certain limited partnerships and limited liability companies holding real estate, securities or loans (as disclosed in Note 11), we maintain a portfolio of operating joint ventures accounted for as equity method investments. Operating joint ventures accounted for under the equity method had a carrying value of $1.1 billion as of December 31, 2022 and $1.2 billion as of December 31, 2021.
For the years ended December 31, 2022, 2021 and 2020, none of our unconsolidated subsidiary investments were individually significant.
Accounting policy. We record in our Consolidated Statements of Income our proportionate share of net income or loss generated by equity method operating joint ventures within Fees and other revenues. In certain instances, income or loss is reported on a one month lag due to the timing of when financial information is received.
The below summarized results of operations and financial position of the operating joint venture investments accounted for under the equity method reflects the latest available financial information and does not represent the Company's proportionate share of the assets, liabilities or earnings of such entities. The net loss for the year ended December 31, 2022 is primarily attributable to realized investment losses as a result of market volatility experienced by our joint venture in China.
For the Years Ended December 31,
(In millions)202220212020
Revenues$4,208 $3,400 $2,457 
Net (loss) income$(15)$200 $401 
(In millions)December 31, 2022December 31, 2021
Total assets$20,676 $18,942 
Total liabilities$18,441 $16,510 
v3.22.4
Accumulated Other Comprehensive Income (Loss)
12 Months Ended
Dec. 31, 2022
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Accumulated Other Comprehensive Income (Loss)
Note 15 – Accumulated Other Comprehensive Income (Loss) ("AOCI")
AOCI includes net unrealized (depreciation) appreciation on securities and derivatives (excluding appreciation on investments supporting future policy benefit liabilities of the run-off settlement annuity business) (see Note 11), foreign currency translation and the net postretirement benefits liability adjustment. AOCI also includes the Company's share from unconsolidated entities accounted for under the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net income in the same period that the related pre-tax AOCI reclassifications are recognized. Changes in the components of AOCI were as follows:
For the Years Ended December 31,
(In millions)202220212020
Securities and Derivatives
Beginning balance$685 $900 $975 
Unrealized (depreciation) appreciation on securities and derivatives
(1,528)(230)776 
Tax benefit (expense)
310 31 (150)
Net unrealized (depreciation) appreciation on securities and derivatives
(1,218)(199)626 
Reclassification adjustment for losses (gains) included in Shareholders' net income (Gain on sale of businesses)
172 — (862)
Reclassification adjustment for losses (gains) included in Shareholders' net income (Net realized investment (losses) gains)
52 (21)(26)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net income
(11)187 
Net losses (gains) reclassified from AOCI to Shareholders' net income
213 (16)(701)
Other comprehensive (loss), net of tax
(1,005)(215)(75)
Ending balance$(320)$685 $900 
Translation of foreign currencies
Beginning balance$(233)$(15)$(275)
Translation of foreign currencies(282)(213)232 
Tax (expense) benefit
(33)(19)12 
Net translation of foreign currencies(315)(232)244 
Reclassification adjustment for losses included in Net income (Gain on sale of businesses)
358 — 11 
Reclassification adjustment for tax expense (benefit) included in Net income
29 — (3)
Net translation losses reclassified from AOCI to Net income
387 — 
Other comprehensive income (loss), net of tax
72 (232)252 
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests
(2)(14)(8)
Shareholders' other comprehensive income (loss), net of tax
74 (218)260 
Ending balance$(159)$(233)$(15)
Postretirement benefits liability
Beginning balance$(1,336)$(1,746)$(1,641)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)
65 85 70 
Reclassification adjustment for (gains) included in Shareholders' net income (Gain on sale of businesses)
(1)— — 
Reclassification adjustment for settlement (Interest expense and other)
 — 
Reclassification adjustment for tax (benefit) included in Shareholders' net income
(16)(21)(17)
Net adjustments reclassified from AOCI to Shareholders' net income
48 68 53 
Valuation update487 448 (206)
Tax (expense) benefit
(115)(106)48 
Net change due to valuation update372 342 (158)
Other comprehensive income (loss), net of tax
420 410 (105)
Ending balance$(916)$(1,336)$(1,746)
Total Accumulated other comprehensive loss
Beginning balance$(884)$(861)$(941)
Shareholders' other comprehensive (loss) income, net of tax
(511)(23)80 
Ending balance$(1,395)$(884)$(861)
v3.22.4
Organizational Efficiency Plan
12 Months Ended
Dec. 31, 2022
Restructuring and Related Activities [Abstract]  
Organizational Efficiency Plan
Note 16 – Organizational Efficiency Plan
During 2021, the Company approved a strategic plan to further leverage its ongoing growth to drive operational efficiency through enhancements to organizational structure and increased use of automation and shared services. As of December 31, 2022, the remaining accrued liability recorded in Accrued expenses and other liabilities was $39 million. We expect substantially all of the accrued liability to be paid by the end of 2023.
v3.22.4
Pension
12 Months Ended
Dec. 31, 2022
Retirement Benefits [Abstract]  
Pension
Note 17 – Pension
A.About Our Plans
The Company sponsors U.S. and non-U.S. defined benefit pension plans; future benefit accruals for the domestic plans are frozen.
Accounting policy. The Company measures the assets and liabilities of its domestic pension plans as of December 31. Benefit obligations are measured at the present value of estimated future payments based on actuarial assumptions. The Company uses the corridor method to account for changes in the benefit obligation when actual results differ from those assumed, or when assumptions change. These changes are called net unrecognized actuarial gains (losses). Under the corridor method, net unrecognized actuarial gains (losses) are initially recorded in Accumulated other comprehensive loss. When the unrecognized gain (loss) exceeds 10% of the benefit obligation, that excess is amortized to expense over the expected remaining lives of plan participants. The net plan expense is reported in Interest expense and other in the Consolidated Statements of Income.
For balance sheet purposes, we measure plan assets at fair value. When the actual return differs from the expected return, those differences are reflected in the net unrealized actuarial gain (loss) discussed above. However, to measure pension benefit costs, we use a market-related asset valuation that differs from the actual fair value for domestic pension plan assets invested in non-fixed income investments. The market-related value recognizes the difference between actual and expected long-term returns in the portfolio over five years, a method that reduces the short-term impact of market fluctuations on pension costs. The market-related asset value was approximately $3.8 billion, compared with a fair value of approximately $4.2 billion at December 31, 2022.

B.Funded Status and Amounts Included in Accumulated Other Comprehensive Loss
The following table summarizes the projected benefit obligations and assets related to our U.S. and non-U.S. pension plans:
For the Years Ended December 31,
(In millions)20222021
Change in benefit obligation
Benefit obligation, January 1$5,223 $5,600 
Service cost2 
Interest cost140 132 
Actuarial (gains), net (1)
(1,094)(189)
Benefits paid from plan assets(296)(304)
Other
(27)(18)
Benefit obligation, December 313,948 5,223 
Change in plan assets
Fair value of plan assets, January 14,846 4,623 
Actual return on plan assets(366)522 
Benefits paid(296)(304)
Contributions2 
Fair value of plan assets, December 314,186 4,846 
Funded status$238 $(377)
Amounts presented in Consolidated Balance Sheets
Other assets
$238 $— 
Accrued expenses and other liabilities
$ $(14)
Other non-current liabilities
$ $(363)
(1) 2022 and 2021 gains reflect an increase in the discount rate.

We fund our qualified pension plans at least at the minimum amount required by the Employee Retirement Income Security Act of 1974 and the Pension Protection Act of 2006. The Company made immaterial contributions to the qualified pension plans in 2022. For 2023, contributions to the qualified pension plans are expected to be immaterial. Future years' contributions will ultimately be based
on a wide range of factors including but not limited to asset returns, discount rates and funding targets. Non-qualified pension plans are generally funded on a pay-as-you-go basis as there are no plan assets for these plans.
Benefit payments. The following benefit payments are expected to be paid in:
(In millions)
2023$320 
2024$316 
2025$316 
2026$316 
2027$313 
2028 - 2032$1,508 

Amounts reflected in the pension assets/(liabilities) shown above that have not yet been reported in Net income and, therefore, have been included in Accumulated other comprehensive loss consisted of the following:
(In millions)December 31, 2022December 31, 2021
Unrecognized net (losses)
$(1,208)$(1,753)
Unrecognized prior service cost(5)(5)
Postretirement benefits liability adjustment$(1,213)$(1,758)
C.Cost of Our Plans
Net pension cost was as follows:
For the Years Ended December 31,
(In millions)202220212020
Service cost$2 $$
Interest cost140 132 168 
Expected long-term return on plan assets(272)(269)(260)
Amortization of:
Prior actuarial losses, net89 78 78 
Settlement loss — 
Net (benefit) cost$(41)$(53)$(12)
D.Assumptions Used for Pension
For the Years Ended December 31,
 20222021
Discount rate:
Pension benefit obligation5.43%2.82%
Pension benefit cost2.82%2.49%
Expected long-term return on plan assets:
Pension benefit cost6.75%6.75%
Mortality table for pension obligationsWhite Collar mortality table with MP 2021 projection scaleWhite Collar mortality table with MP 2021 projection scale
The Company develops discount rates by applying actual annualized yields for high-quality bonds by duration to the expected pension plan liability cash flows. The bond yields represent a diverse mix of actively traded high quality fixed-income securities that have an above average return at each duration as management believes this approach is representative of the yield achieved through plan asset investment strategy.
The expected long-term return on plan assets was developed considering historical long-term actual returns, expected long-term market conditions, plan asset mix and management's plan asset investment strategy.
E.Pension Plan Assets
As of December 31, 2022, pension assets included $4.0 billion invested in the separate accounts of Connecticut General Life Insurance Company, a subsidiary of the Company, and an additional $0.2 billion invested in funds of unaffiliated investment managers.

The fair values of pension assets by category are as follows:
(In millions)December 31, 2022December 31, 2021
Debt securities:
Federal government and agency$11 $
Corporate2,349 1,653 
Asset-backed109 108 
Fund investments478 731 
Total debt securities2,947 2,501 
Equity securities:
Domestic89 789 
International, including funds and pooled separate accounts (1)
35 358 
Total equity securities124 1,147 
Securities partnerships452 514 
Real estate funds, including pooled separate accounts (1)
315 334 
Commercial mortgage loans63 77 
Hedge funds — 
Guaranteed deposit account contract50 91 
Cash equivalents and other current assets, net235 182 
Total pension assets at fair value$4,186 $4,846 
(1) A pooled separate account has several participating benefit plans and each owns a share of the total pool of investments.
The Company's current target investment allocation percentages are 80% fixed income and 20% in other investments, including private equity (securities partnerships), public equity securities, and real estate, and are developed by management as guidelines, although the fair values of each asset category are expected to vary as a result of changes in market conditions. These allocation percentages were updated during 2022 to increase the allocation to fixed income investments as a result of improvements in the plan's funding status, as interest rates increased during the year. The Company will evaluate further allocation changes to equity securities, other investments and fixed income securities as funding levels change.

See Note 12 for further details regarding how fair value is determined, including the level within the fair value hierarchy and the procedures we use to validate fair value measurements. The Company classifies substantially all debt securities in Level 2 for pension plan assets. These assets are valued using recent trades of similar securities or are fund investments priced using their daily net asset value that is the exit price. Approximately one-third of equity securities are classified in Level 1 because they are priced according to unadjusted quotes from active markets, while another one-third of this balance is classified in Level 2 and priced using the daily net asset value. The remaining balance of equity securities is classified in Level 3.
Securities partnerships, real estate and hedge funds are valued using net asset value as a practical expedient and are excluded from the fair value hierarchy. See Note 12 for additional disclosures related to these assets invested in the separate accounts of the Company's subsidiary. Certain securities as described in Note 12, as well as commercial mortgage loans and guaranteed deposit account contracts, are classified in Level 3 because unobservable inputs used in their valuation are significant.
F.401(k) Plan
The Company sponsors a 401(k) plan. All employees are immediately eligible for the plan at hire and the Company matches a portion of employees' contributions to the plan. Participants in the plan may invest in various funds that invest in the Company's common stock, several diversified stock funds, a bond fund or stable value funds. The Company common stock fund under the plan constitutes
an "employee stock ownership plan" as defined in the Internal Revenue Code. Dividends from the Company common stock fund are reinvested in a participant's stock fund account unless the participant elects to receive the dividends in cash.
The Company may elect to increase its matching contributions if the Company's annual performance meets certain targets. The Company's annual expense for the plan was as follows:
For the Years Ended December 31,
(In millions)202220212020
Expense$274 $268 $243 
v3.22.4
Employee Incentive Plans
12 Months Ended
Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]  
Employee Incentive Plans
Note 18 – Employee Incentive Plans
A.About Our Plans
The People Resources Committee (the "Committee") of the Board of Directors awards stock options, restricted stock grants, restricted stock units, deferred stock and strategic performance shares to certain employees. The Company issues original issue shares for these awards.
The Company records compensation expense for stock and option awards over their vesting periods primarily based on the estimated fair value at the grant date. Fair value is determined differently for each type of award as discussed below.
Shares of common stock available for award were as follows:
(In millions)December 31, 2022December 31, 2021December 31, 2020
Common shares available for award16.6 19.1 20.6 
B.Stock Options
Accounting policy. The Company awards options to purchase The Cigna Group common stock at the market price of the stock on the grant date. Options vest over periods ranging from one year to three years and expire no later than 10 years from grant date. Fair value is estimated using the Black-Scholes option-pricing model by applying the assumptions presented below. That fair value is reduced by options expected to be forfeited during the vesting period. The Company estimates forfeitures at the grant date based on our experience and adjusts the expense to reflect actual forfeitures over the vesting period. The fair value of options, net of forfeitures, is recognized in Selling, general and administrative expenses on a straight-line basis over the vesting period.
Black-Scholes option-pricing model assumptions and the resulting fair value of options are presented in the following table:
 202220212020
Dividend yield1.98 %1.85 %— %
Expected volatility30.0 %30.0 %30.0 %
Risk-free interest rate1.6 %0.5 %1.4 %
Expected option life4.5 years4.5 years4.5 years
Weighted average fair value of options$50.61 $44.84 $52.42 
The dividend yield reflects expected future dividends. The Company intends to continue to pay dividends for the foreseeable future. The expected volatility reflects the past daily stock price volatility of The Cigna Group stock. The Company does not consider volatility implied in the market prices of traded options to be a good indicator of future volatility because remaining traded options will expire within one year. The risk-free interest rate is derived using the four-year U.S. Treasury bond yield rate as of the award date for the primary annual grant. Expected option life reflects the Company's historical experience.
The following table shows the status of, and changes in, common stock options:
For the Years Ended December 31,
202220212020
(Options in thousands)OptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise Price
Outstanding - January 18,490 $169.47 9,742 $152.40 11,438 $136.19 
Granted1,375 $226.95 1,524 $213.81 1,851 $191.86 
Exercised(2,617)$149.97 (2,584)$129.08 (3,289)$115.38 
Expired or canceled(256)$211.22 (192)$199.10 (258)$188.79 
Outstanding - December 316,992 $186.54 8,490 $169.47 9,742 $152.40 
Options exercisable at year-end4,410 $168.97 5,612 $152.92 6,837 $137.08 
Compensation expense of $63 million related to unvested stock options at December 31, 2022 will be recognized over the next two years (weighted average period).
The table below summarizes information for stock options exercised:
For the Years Ended December 31,
(In millions)202220212020
Intrinsic value of options exercised$313 $268 $304 
Cash received for options exercised$389 $326 $376 
Tax benefit from options exercised$47 $50 $57 
The following table summarizes information for outstanding common stock options:
December 31, 2022
 Options
Outstanding
Options
Exercisable
Number (in thousands)6,992 4,410 
Total intrinsic value (in millions)$1,012 $716 
Weighted average exercise price$186.54 $168.97 
Weighted average remaining contractual life6.2 years4.9 years
C.Restricted Stock
The Company awards restricted stock (grants and units) to the Company's employees that vest over periods ranging from one to three years. Recipients of restricted stock awards accumulate dividends during the vesting period, but generally forfeit their awards and accumulated dividends if their employment terminates before the vesting date.
Accounting policy. Fair value of restricted stock awards is equal to the market price of The Cigna Group's common stock on the date of grant. This fair value is reduced by awards that are expected to forfeit. At the grant date, the Company estimates forfeitures based on experience and adjusts the expense to reflect actual forfeitures over the vesting period. This fair value, net of forfeitures, is recognized in Selling, general and administrative expenses over the vesting period on a straight-line basis.
The following table shows the status of, and changes in, restricted stock awards:
For the Years Ended December 31,
202220212020
(Awards in thousands)Grants/UnitsWeighted Average Fair Value at Award DateGrants/UnitsWeighted Average Fair Value at Award DateGrants/UnitsWeighted Average Fair Value at Award Date
Outstanding - January 11,524 $202.85 1,600 $186.12 1,945 $178.78 
Awarded876 $229.60 899 $213.82 791 $191.22 
Vested(714)$197.83 (866)$184.07 (1,026)$161.58 
Forfeited(151)$215.02 (109)$197.01 (110)$186.63 
Outstanding - December 311,535 $219.25 1,524 $202.85 1,600 $186.12 
The fair value of vested restricted stock at the vesting date was as follows:
For the Years Ended December 31,
(In millions)202220212020
Fair value of vested restricted stock$167 $183 $190 
Approximately 10,000 employees held 1.5 million restricted stock awards at the end of 2022 with $182 million of related compensation expense to be recognized over the next two years (weighted average period).
D.Strategic Performance Shares ("SPS")
The Company awards SPSs to executives and certain other key employees generally with a performance period of three years. Half of these shares are subject to a market condition (total shareholder return relative to industry peer companies) and half are subject to a performance condition (cumulative adjusted net income). These targets are set by the Committee at the beginning of the performance period. Holders of these awards receive shares of The Cigna Group common stock at the end of the performance period ranging anywhere from 0 to 200% of the original awards.
Accounting policy. Compensation expense for SPSs is recorded over the performance period. Fair value is determined at the grant date for "market condition" SPSs using a Monte Carlo simulation model and not subsequently adjusted regardless of the final outcome. Expense is initially accrued for "performance condition" SPSs based on the most likely outcome, but evaluated for adjustment each period for updates in the expected outcome. Expense is adjusted to the actual outcome (number of shares awarded times the share price at the grant date) at the end of the performance period.
The following table shows the status of, and changes in, SPSs:
For the Years Ended December 31,
 202220212020
(Awards in thousands)SharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award Date
Outstanding - January 1860 $197.07 808 $190.02 818 $177.94 
Awarded294 $230.69 331 $213.90 362 $191.52 
Vested(261)$183.60 (206)$196.29 (309)$159.67 
Forfeited(113)$207.75 (73)$197.38 (63)$187.76 
Outstanding - December 31780 $212.68 860 $197.07 808 $190.02 
The weighted average fair value per share of SPSs for expense purposes, including the Monte Carlo factor, at the award date for the years ended December 31, 2022, 2021 and 2020 was $258.37, $239.57 and $206.86, respectively.
The fair value of vested SPSs at the vesting date was as follows:
For the Years Ended December 31,
 202220212020
(Shares in thousands; $ in millions)SharesFair ValueSharesFair ValueSharesFair Value
Shares of The Cigna Group common stock distributed upon SPS vesting137 $31 243 $51 306 $55 
Approximately 500 employees held 780,000 SPSs at the end of 2022 and $69 million of related compensation expense is expected to be recognized over the next two years. The amount of expense for "performance condition" SPSs will vary based on actual performance in 2023 and 2024.
E.Compensation Cost and Tax Effects of Share-based Compensation
The Company records tax benefits in Shareholders' net income during the vesting period based on the amount of expense being recognized. The difference between tax benefits based on the expense and the actual tax benefit realized are also recorded in Net income when stock options are exercised, or when restricted stock and SPSs vest.
For the Years Ended December 31,
(In millions)202220212020
Total compensation cost for shared-based awards$264 $268 $289 
Tax benefits recognized$80 $73 $63 
v3.22.4
Goodwill, Other Intangibles and Property and Equipment
12 Months Ended
Dec. 31, 2022
Goodwill Other Intangibles And Property And Equipment [Abstract]  
Goodwill, Other Intangibles, and Property and Equipment
Note 19 – Goodwill, Other Intangibles and Property and Equipment
A.Goodwill
Accounting policy. Goodwill represents the excess of the cost of businesses acquired over the fair value of their net assets. The resulting goodwill is assigned to those reporting units expected to realize cash flows from the acquisition, based on those reporting units' relative fair values. The Company's reporting units are aligned with its operating segments as described in Note 1.
The Company conducts its annual quantitative evaluation for goodwill impairment during the third quarter at the reporting unit level and writes it down through shareholders' net income if impaired. On a quarterly basis, the Company performs a qualitative impairment assessment to determine if events or changes in circumstances indicate that it is more likely than not that the carrying value of a reporting unit exceeds its estimated fair value. Fair value of a reporting unit is generally estimated based on discounted cash flow analysis and market approach models using assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. The significant assumptions and estimates used in determining fair value primarily include the discount rate and future cash flows. A discount rate is selected to correspond with each reporting unit's weighted average cost of capital, consistent with that used for investment decisions considering the specific and detailed operating plans and strategies within each reporting unit. Projections of future cash flows differ by reporting unit and are consistent with our ongoing strategic projections. Future cash flows for Evernorth Health Services are primarily driven by the forecasted gross margins of the business, as well as operating expenses and long-term growth rates. Future cash flows for our other reporting units are primarily driven by forecasted revenues, benefit expenses, operating expenses and long-term growth rates.
Goodwill activity. Goodwill activity was as follows:
(In millions)Evernorth Health ServicesCigna HealthcareOther OperationsTotal
Balance at January 1, 2021
$33,806 $10,577 $265 $44,648 
Goodwill acquired1,322 116 — 1,438 
Goodwill disposed— (10)— (10)
Impact of foreign currency translation and other adjustments— — (31)(31)
Goodwill at December 31, 2021 (1)
35,128 10,683 234 46,045 
Goodwill disposed  (234)(234)
Impact of foreign currency translation and other adjustments2 (2)  
Goodwill at December 31, 2022
$35,130 $10,681 $ $45,811 
(1) Includes $234 million classified as Assets of businesses held for sale, all reported within Other Operations.
B.Other Intangible Assets
Accounting policy. The Company's Other intangible assets primarily include purchased customer and producer relationships, provider networks and trademarks. The fair value of purchased customer relationships and the amortization method were determined as of the dates of purchase using an income approach that relies on projected future net cash flows including key assumptions for customer attrition and discount rates. The Company's definite-lived intangible assets are amortized on an accelerated or straight-line basis, reflecting their pattern of economic benefits, over periods from three to 30 years. Management revises amortization periods if it believes there has been a change in the length of time that an intangible asset will continue to have value. Costs incurred to renew or extend the terms of these intangible assets are generally expensed as incurred.
The Company's amortized intangible assets are tested for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. If the total of the expected future undiscounted cash flows generated by the underlying asset group is less than the carrying amount of the asset group, the Company recognizes an impairment charge equal to the difference between the carrying value of the asset group and its estimated fair value. The Company's indefinite-lived intangible assets are reviewed for impairment at least annually by comparing their fair value with their carrying value. If the carrying value exceeds fair value, that excess is recognized as an impairment loss.
There were no material impairments in the years ended December 31, 2022, 2021 or 2020.
Components of other assets, including other intangibles. Other intangible assets were comprised of the following:
(In millions)CostAccumulated AmortizationNet Carrying Value
December 31, 2022   
Customer relationships$29,974 6,099 23,875 
Trade Name - Express Scripts8,400 8,400 
Other348 131 217 
Other intangible assets38,722 6,230 32,492 
Value of business acquired ("VOBA" reported in Other assets)
210 133 77 
Total $38,932 6,363 32,569 
December 31, 2021
Customer relationships$29,997 4,539 25,458 
Trade Name - Express Scripts8,400 8,400 
Other447 81 366 
Other intangible assets38,844 4,620 34,224 
Value of business acquired (reported in Other assets)
646 171 475 
Total (1)
$39,490 4,791 34,699 
(1) Includes $386 million of VOBA and $122 million of Other intangible assets intangible assets classified as Assets of businesses held for sale.
The Company has indefinite-lived intangible assets totaling $8.5 billion at December 31, 2022 and December 31, 2021, largely consisting of trade names and licenses.
C.Property and Equipment
Accounting policy. Property and equipment is carried at cost less accumulated depreciation. Cost includes interest, real estate taxes and other costs incurred during construction when applicable. Internal-use software that is acquired, developed or modified solely to
meet the Company's internal needs, with no plan to market externally, is also included in this category. Costs directly related to acquiring, developing or modifying internal-use software are capitalized.
The Company calculates depreciation and amortization principally using the straight-line method generally based on the estimated useful life of each asset as follows: buildings and improvements, 10 to 40 years; purchased software, three to five years; internally developed software, three to seven years and furniture and equipment (including computer equipment), three to 10 years. Improvements to leased facilities are depreciated over the lesser of the remaining lease term or the estimated life of the improvement. The Company considers events and circumstances that would indicate the carrying value of property, equipment or capitalized software might not be recoverable. An impairment charge is recorded if the Company determines the carrying value of any of these assets is not recoverable. The Company also reviews and shortens the estimated useful lives of these assets, if necessary.
Components of property and equipment. Property and equipment was comprised of the following:
(In millions)CostAccumulated AmortizationNet Carrying Value
December 31, 2022   
Internal-use software$8,948 $6,100 $2,848 
Other property and equipment2,256 1,330 926 
Total property and equipment$11,204 $7,430 $3,774 
December 31, 2021
Internal-use software$7,869 $5,060 $2,809 
Other property and equipment2,839 1,653 1,186 
Total10,708 6,713 3,995 
Property and equipment classified as Assets of businesses held for sale
(424)(121)(303)
Total Property and equipment per Consolidated Balance Sheets$10,284 $6,592 $3,692 
Components of depreciation and amortization. Depreciation and amortization expense was comprised of the following:
For the Years Ended December 31,
(In millions)202220212020
Internal-use software$1,068 $1,097 $971 
Other property and equipment251 253 276 
Value of business acquired (reported in Other assets)
12 25 28 
Other intangibles1,606 1,548 1,527 
Total depreciation and amortization$2,937 $2,923 $2,802 
The Company estimates annual pre-tax amortization for intangible assets, including internal-use software, over the next five calendar years to be as follows:
(In millions)Pre-tax Amortization
2023$2,804 
2024$2,302 
2025$1,988 
2026$1,583 
2027$1,523 
v3.22.4
Leases
12 Months Ended
Dec. 31, 2022
Leases [Abstract]  
Leases Note 20 – Leases
The Company's leases are primarily for office space and certain computer and other equipment and have terms of up to 35 years.
Accounting policy. The Company determines if an arrangement is a lease and its lease classification (operating or finance) at inception. Both operating and finance leases result in (1) a right-of-use ("ROU") asset that represents our right to use the underlying asset for the lease term and (2) a lease liability that represents our obligation to make lease payments arising from the lease. ROU
assets and lease liabilities are reflected in the following lines in the Company's Consolidated Balance Sheets:
  ROU Asset Current Lease Liability Non-Current Lease Liability
Operating lease Other assets Accrued expenses and other liabilities (current) Other liabilities (non-current)
Finance lease Property and equipment Short-term debt Long-term debt
These lease assets and liabilities are recognized at the lease commencement date based on the present value of the lease payments over the lease term. Most of the Company's leases do not provide an implicit rate, so the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The ROU asset also includes any lease pre-payments made and excludes lease incentives for operating leases. The Company's expected life of a lease may consider options to extend or terminate a lease when it is reasonably certain that the Company will exercise that option.
The Company has lease agreements with lease and non-lease components that are accounted for as a single lease component. Operating lease ROU assets are amortized on a straight-line basis over the lease term, which is representative of the pattern in which benefit is expected to be derived from the right to use the underlying asset. Variable lease payments are expensed as incurred and represent amounts that are neither fixed in nature, such as maintenance and other services provided by the lessor, nor tied to an index or rate.
The components of lease expense were as follows:
For the Years Ended December 31,
(In millions)202220212020
Operating lease cost$124 $170 $190 
Finance lease cost:
Amortization of ROU assets33 22 28 
Interest on lease liabilities2 
Total finance lease cost35 24 31 
Variable lease cost41 39 48 
Total lease cost$200 $233 $269 

Supplemental cash flow information related to leases was as follows:
For the Years Ended December 31,
(In millions)202220212020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$148 $167 $189 
Operating cash outflows from finance leases$2 $$
Financing cash outflows from finance leases$33 $22 $26 
 
ROU assets obtained in exchange for lease obligations:
Operating leases$43 $122 $189 
Finance leases$84 $20 $
Operating and finance lease right-of-use ("ROU") assets and lease liabilities were as follows:
(In millions)December 31, 2022December 31, 2021
Operating leases: (1)
Operating lease ROU assets in Other assets
$375 $478 
Accrued expenses and other liabilities$114 $159 
Other non-current liabilities346 436 
Total operating lease liabilities$460 $595 
Finance leases:
Property and equipment, gross$145 $101 
Accumulated depreciation(48)(51)
Property and equipment, net$97 $50 
Short-term debt$33 $23 
Long-term debt66 28 
Total finance lease liabilities$99 $51 
(1) Operating leases include $27 million as of December 31, 2021 classified as Assets of businesses held for sale and $28 million as of December 31, 2021 classified as Liabilities of businesses held for sale.
As of December 31, 2022, the weighted average remaining lease term was 5 years for operating leases and 3 years for finance leases, and the weighted average discount rate was 2.80% for operating leases and 3.45% for finance leases.
Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2023$114 $35 
2024111 31 
202584 24 
202664 10 
202747 3 
Thereafter74 2 
Total lease payments494 105 
Less: imputed interest34 6 
Total$460 $99 
Leases Note 20 – Leases
The Company's leases are primarily for office space and certain computer and other equipment and have terms of up to 35 years.
Accounting policy. The Company determines if an arrangement is a lease and its lease classification (operating or finance) at inception. Both operating and finance leases result in (1) a right-of-use ("ROU") asset that represents our right to use the underlying asset for the lease term and (2) a lease liability that represents our obligation to make lease payments arising from the lease. ROU
assets and lease liabilities are reflected in the following lines in the Company's Consolidated Balance Sheets:
  ROU Asset Current Lease Liability Non-Current Lease Liability
Operating lease Other assets Accrued expenses and other liabilities (current) Other liabilities (non-current)
Finance lease Property and equipment Short-term debt Long-term debt
These lease assets and liabilities are recognized at the lease commencement date based on the present value of the lease payments over the lease term. Most of the Company's leases do not provide an implicit rate, so the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The ROU asset also includes any lease pre-payments made and excludes lease incentives for operating leases. The Company's expected life of a lease may consider options to extend or terminate a lease when it is reasonably certain that the Company will exercise that option.
The Company has lease agreements with lease and non-lease components that are accounted for as a single lease component. Operating lease ROU assets are amortized on a straight-line basis over the lease term, which is representative of the pattern in which benefit is expected to be derived from the right to use the underlying asset. Variable lease payments are expensed as incurred and represent amounts that are neither fixed in nature, such as maintenance and other services provided by the lessor, nor tied to an index or rate.
The components of lease expense were as follows:
For the Years Ended December 31,
(In millions)202220212020
Operating lease cost$124 $170 $190 
Finance lease cost:
Amortization of ROU assets33 22 28 
Interest on lease liabilities2 
Total finance lease cost35 24 31 
Variable lease cost41 39 48 
Total lease cost$200 $233 $269 

Supplemental cash flow information related to leases was as follows:
For the Years Ended December 31,
(In millions)202220212020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$148 $167 $189 
Operating cash outflows from finance leases$2 $$
Financing cash outflows from finance leases$33 $22 $26 
 
ROU assets obtained in exchange for lease obligations:
Operating leases$43 $122 $189 
Finance leases$84 $20 $
Operating and finance lease right-of-use ("ROU") assets and lease liabilities were as follows:
(In millions)December 31, 2022December 31, 2021
Operating leases: (1)
Operating lease ROU assets in Other assets
$375 $478 
Accrued expenses and other liabilities$114 $159 
Other non-current liabilities346 436 
Total operating lease liabilities$460 $595 
Finance leases:
Property and equipment, gross$145 $101 
Accumulated depreciation(48)(51)
Property and equipment, net$97 $50 
Short-term debt$33 $23 
Long-term debt66 28 
Total finance lease liabilities$99 $51 
(1) Operating leases include $27 million as of December 31, 2021 classified as Assets of businesses held for sale and $28 million as of December 31, 2021 classified as Liabilities of businesses held for sale.
As of December 31, 2022, the weighted average remaining lease term was 5 years for operating leases and 3 years for finance leases, and the weighted average discount rate was 2.80% for operating leases and 3.45% for finance leases.
Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2023$114 $35 
2024111 31 
202584 24 
202664 10 
202747 3 
Thereafter74 2 
Total lease payments494 105 
Less: imputed interest34 6 
Total$460 $99 
v3.22.4
Shareholders Equity and Dividend Restrictions
12 Months Ended
Dec. 31, 2022
Equity [Abstract]  
Shareholders' Equity And Dividend Restrictions
Note 21 – Shareholders' Equity and Dividend Restrictions
State insurance departments and foreign jurisdictions that regulate certain of the Company's subsidiaries prescribe accounting practices (differing in some respects from GAAP) to determine statutory net income and surplus. The Company's life, accident and health insurance and Health Maintenance Organization ("HMO") subsidiaries are regulated by such statutory requirements. The statutory net income of the Company's life, accident and health insurance and HMO subsidiaries for the years ended, and their statutory surplus as of December 31 were as follows:
(In billions)202220212020
Net income$5.7 $3.4 $4.0 
Surplus$16.4 $13.3 $12.9 
The Company's HMO and life, accident and health insurance subsidiaries are also subject to minimum statutory surplus requirements and may be required to maintain investments on deposit with state departments of insurance or other regulatory bodies. Additionally, these subsidiaries may be subject to regulatory restrictions on the amount of annual dividends or other distributions (such as loans or cash advances) that insurance companies may extend to their parent companies without prior approval. These amounts, including restricted GAAP net assets of the Company's subsidiaries, were as follows:
(In billions)December 31, 2022
Minimum statutory surplus required by regulators (1)
$4.2 
Investments on deposit with regulatory bodies$0.3 
Maximum dividend distributions permitted in 2023 without regulatory approval
$3.2 
Maximum loans to the parent company permitted without regulatory approval$1.4 
Restricted GAAP net assets of The Cigna Group's subsidiaries$14.8 
(1) Excludes amounts associated with foreign operated equity method joint ventures.

Permitted practices used by the Company's insurance subsidiaries in 2022 that differed from prescribed regulatory accounting had an immaterial impact on statutory surplus.

Undistributed earnings for equity method investments are $1.2 billion as of December 31, 2022.
v3.22.4
Income Taxes
12 Months Ended
Dec. 31, 2022
Income Tax Disclosure [Abstract]  
Income Taxes Note 22 – Income Taxes
Accounting policy. Deferred income taxes are reflected in the Consolidated Balance Sheets for differences between the financial and income tax reporting bases of the Company's underlying assets and liabilities, and are established based upon enacted tax rates and laws. Deferred income tax assets are recognized when available evidence indicates that realization is more likely than not and a valuation allowance is established to the extent this standard is not met. The deferred income tax provision generally represents the net change in deferred income tax assets and liabilities during the reporting period excluding adjustments to Accumulated other comprehensive income (loss) or amounts recorded in connection with a business combination. The current income tax provision generally represents estimated amounts due on income tax returns for the year reported to various jurisdictions plus the effect of any uncertain tax positions. The Company recognizes a liability for uncertain tax positions if management believes the probability that the positions will be sustained is 50% or less. For uncertain positions that management believes are more likely than not to be sustained, the Company recognizes a liability based upon management's estimate of the most likely settlement outcome with the taxing authority. The liabilities for uncertain tax positions are classified as current when the position is expected to be settled within 12 months or the statute of limitation expires within 12 months.
Income taxes attributable to the Company's foreign operations are generally provided using the respective foreign jurisdictions' tax rate.
A.Income Tax Expense
The components of income taxes were as follows:
For the Years Ended December 31,
(In millions)202220212020
Current taxes
U.S. income taxes$1,679 $1,268 $2,128 
Foreign income taxes219 207 334 
State income taxes189 112 303 
Total current taxes2,087 1,587 2,765 
Deferred taxes (benefits)
U.S. income tax benefits
(283)(167)(217)
Foreign income (tax benefits) taxes
(28)69 11 
State income tax benefits
(169)(122)(180)
Total deferred tax benefits
(480)(220)(386)
Total income taxes$1,607 $1,367 $2,379 
Total income taxes were different from the amount computed using the nominal federal income tax rate for the following reasons:
For the Years Ended December 31,
 202220212020
(In millions)$%$%$%
Tax expense at nominal rate$1,754 21.0 %$1,424 21.0 %$2,282 21.0 %
Impact of sale of businesses(37)(0.4)— — 104 1.0 
Effect of foreign earnings(96)(1.2)(33)(0.5)(61)(0.6)
Health insurance industry tax  — — 93 0.9 
State income tax (benefit), net of federal income tax benefit
16 0.2 (9)(0.1)24 0.2 
Other(30)(0.4)(15)(0.2)(63)(0.6)
Total income taxes$1,607 19.2 %$1,367 20.2 %$2,379 21.9 %
Consolidated pre-tax income from the Company's foreign operations was approximately 46% of the Company's pre-tax income in 2022, 26% in 2021 and 14% in 2020. The increase over 2021 is primarily driven by the gain from the Chubb transaction, an increase to the Company's international pharmaceutical operations, partially offset by a reduction in earnings from the sold entities.
B.Deferred Income Taxes
Deferred income tax assets and liabilities were as follows:
(In millions)December 31, 2022December 31, 2021
Deferred tax assets
Employee and retiree benefit plans$189 $304 
Other insurance and contractholder liabilities311 263 
Loss carryforwards205 278 
Other accrued liabilities265 412 
Policy acquisition expenses41 — 
Unrealized depreciation on investments and foreign currency translation156 — 
Other190 246 
Deferred tax assets before valuation allowance1,357 1,503 
Valuation allowance for deferred tax assets(208)(246)
Deferred tax assets, net of valuation allowance1,149 1,257 
Deferred tax liabilities
Depreciation and amortization512 698 
Acquisition-related basis differences8,347 8,726 
Policy acquisition expenses 312 
Unrealized appreciation on investments and foreign currency translation 104 
Other41 212 
Total deferred tax liabilities8,900 10,052 
Net deferred income tax liabilities
(8,795)
Net deferred income tax liabilities classified as Liabilities of businesses held for sale
(449)
Net deferred income tax liabilities per Consolidated Balance Sheets
$(7,751)$(8,346)
Management believes that future results will be sufficient to realize a majority of the Company's gross deferred tax assets. As of December 31, 2022, we had approximately $270 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are primarily recorded in Accumulated other comprehensive loss. We have determined that a valuation allowance against the DTAs is not currently required based on the Company's ability to carryback losses and other known investment strategies. We will monitor and evaluate the need for any valuation allowance in the future. Valuation allowances are established against deferred tax assets when it is determined that it is more likely than not that the asset will not be recognized. Valuation allowances have been established against certain federal, state and foreign tax attributes. There are multiple expiration dates associated with these tax attributes.
C.Uncertain Tax Positions
Reconciliations of unrecognized tax benefits were as follows:
For the Years Ended December 31,
(In millions)202220212020
Balance at January 1,$1,230 $1,210 $1,018 
Increase due to prior year positions8 21 128 
Increase due to current year positions137 31 88 
Reduction related to settlements with taxing authorities(4)(15)— 
Reduction related to lapse of applicable statute of limitations(28)(17)(24)
Balance at December 31,$1,343 $1,230 $1,210 
Substantially all unrecognized tax benefits would impact Shareholders' net income if recognized.
The Company classifies net interest expense on uncertain tax positions as a component of income tax expense and in Other non-current liabilities in the Consolidated Balance Sheets. In addition to the amounts in the table above, the liability for net interest expense on uncertain tax positions was approximately $176 million as of December 31, 2022, $148 million as of December 31, 2021 and $127 million as of December 31, 2020.
D.Other Tax Matters
The statutes of limitations for The Cigna Group's consolidated federal income tax returns through 2016 have closed. However, The Cigna Group filed amended returns for both the 2015 and 2016 tax years, which are under review by the Internal Revenue Service ("IRS"). Additionally, the IRS is examining The Cigna Group's returns for 2017 and 2018. The statutes of limitations for Express Scripts' consolidated federal income tax returns through 2012 has closed. However, for 2010 through 2012 tax years, there remains a significant disputed matter. The IRS is also examining Express Scripts' consolidated federal income tax returns for 2013 through 2018. The Company has established adequate reserves for these matters.
The Company conducts business in a number of state and foreign jurisdictions and may be engaged in multiple audit proceedings at any given time. Generally, no further state or foreign audit activity is expected for tax years prior to 2013 for The Cigna Group's entities and 2010 for Express Scripts' entities.
v3.22.4
Contingencies and Other Matters
12 Months Ended
Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]  
Contingencies and Other Matters
Note 23 – Contingencies and Other Matters
The Company, through its subsidiaries, is contingently liable for various guarantees provided in the ordinary course of business.
A.Financial Guarantees: Retiree and Life Insurance Benefits
The Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments. As of December 31, 2022, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $420 million. An additional liability is established if management believes that the Company will be required to make payments under the guarantees; there were no additional liabilities required for these guarantees, net of reinsurance, as of December 31, 2022. Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.
The Company does not expect that these financial guarantees will have a material effect on the Company's consolidated results of operations, liquidity or financial condition.
B.Certain Other Guarantees
The Company had indemnification obligations as of December 31, 2022 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with law or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is
possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation. There were no liabilities for these indemnification obligations as of December 31, 2022.
C.Guaranty Fund Assessments
The Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions.
There were no material charges or credits resulting from existing or new guaranty fund assessments for the year ended December 31, 2022.
Legal and Regulatory MattersThe Company is routinely involved in numerous claims, lawsuits, regulatory inquiries and audits, government investigations, including under the federal False Claims Act and state false claims acts initiated by a government investigating body or by a qui tam relator's filing of a complaint under court seal, and other legal matters arising, for the most part, in the ordinary course of managing a global health company. Additionally, the Company has received and is cooperating with subpoenas or similar processes from various governmental agencies requesting information, all arising in the normal course of its business. Disputed tax matters arising from audits by the Internal Revenue Service or other state and foreign jurisdictions, including those resulting in litigation, are accounted for under GAAP guidance for uncertain tax positions, as described in Note 22.Pending litigation and legal or regulatory matters that the Company has identified with a reasonably possible material loss and certain other material litigation matters are described below. For those matters that the Company has identified with a reasonably possible material loss, the Company provides disclosure in the aggregate of accruals and range of loss, or a statement that such information cannot be estimated. The Company's accruals for the matters discussed below under "Litigation Matters" and "Regulatory Matters" are not material. Due to numerous uncertain factors presented in these cases, it is not possible to estimate an aggregate range of loss (if any) for these matters at this time. In light of the uncertainties involved in these matters, there is no assurance that their ultimate resolution will not exceed the amounts currently accrued by the Company. An adverse outcome in one or more of these matters could be material to the Company's results of operations, financial condition or liquidity for any particular period. The outcomes of lawsuits are inherently unpredictable and we may be unsuccessful in these ongoing litigation matters or any future claims or litigation.
Litigation Matters
Express Scripts Litigation with Elevance. In March 2016, Elevance filed a lawsuit in the United States District Court for the Southern District of New York alleging various breach of contract claims against Express Scripts relating to the parties' rights and obligations under the periodic pricing review section of the pharmacy benefit management agreement between the parties including allegations that Express Scripts failed to negotiate new pricing concessions in good faith, as well as various alleged service issues. Elevance also requested that the court enter declaratory judgment that Express Scripts is required to provide Elevance competitive benchmark pricing, that Elevance can terminate the agreement and that Express Scripts is required to provide Elevance with post-termination services at competitive benchmark pricing for one year following any termination by Elevance. Elevance claimed it is entitled to $13 billion in additional pricing concessions over the remaining term of the agreement, as well as $1.8 billion for one year following any contract termination by Elevance and $150 million damages for service issues ("Elevance's Allegations"). On April 19, 2016, in response to Elevance's complaint, Express Scripts filed its answer denying Elevance's Allegations in their entirety and asserting affirmative defenses and counterclaims against Elevance. The court subsequently granted Elevance's motion to dismiss two of six counts of Express Scripts' amended counterclaims. Express Scripts filed its Motion for Summary Judgment on August 27, 2021. Elevance completed filing of its Response to Express Scripts' Motion for Summary Judgment on October 16, 2021. Express Scripts filed its Reply in Support of its Motion for Summary Judgment on November 19, 2021. On March 31, 2022, the court granted summary judgment in favor of Express Scripts on all of Elevance's pricing claims for damages totaling $14.8 billion and on most of Elevance's claims relating to service issues. Elevance's only remaining service claims relate to the review or processing of prior authorizations. On June 10, 2022, Express Scripts filed a Motion for Partial Summary Judgment seeking to limit Elevance's remaining prior authorization claims and a Motion to Exclude certain opinions offered by its experts. Elevance filed its opposition to both motions, and a cross-motion to submit a supplemental expert report, on July 9, 2022. Express Scripts' pending Motions were fully briefed at the end of July 2022.

Medicare Advantage. A qui tam action that was filed by a private individual on behalf of the government in the United States District Court for the Southern District of New York in 2017 was unsealed on August 6, 2020. The action asserts claims related to risk adjustment practices arising from certain health exams conducted as part of the Company's Medicare Advantage business. In September 2021, the qui tam action was transferred to the United States District Court for the Middle District of Tennessee. On
January 11, 2022, the U.S. Department of Justice ("DOJ") (U.S. Attorney's Offices for the Southern District of New York and the Middle District of Tennessee) filed a motion to partially intervene, which was granted on August 2, 2022. On October 14, 2022, the DOJ filed its complaint-in-intervention alleging that certain diagnoses made during in-home exams were invalid for risk adjustment purposes, seeking unspecified damages and penalties under the federal False Claims Act. The Company filed motions to dismiss the DOJ's complaint and the remainder of the qui tam complaint on December 16, 2022. Briefing is ongoing.
Regulatory Matters
Civil Investigative Demand. The DOJ is conducting industry-wide investigations of Medicare Advantage organizations' risk adjustment practices. For certain Medicare Advantage organizations, including The Cigna Group, those investigations have resulted in litigation (see "Litigation Matters—Medicare Advantage" above). The Company is currently responding to information requests (civil investigative demands) from the DOJ (U.S. Attorney's Office for the Eastern District of Pennsylvania). The Company is cooperating with the DOJ and continues to respond to its requests.
v3.22.4
Segment Information
12 Months Ended
Dec. 31, 2022
Segment Reporting [Abstract]  
Segment Information
Note 24 – Segment Information
See Note 1 for a description of our segments. On February 13, 2023, we changed the name of our Evernorth segment to Evernorth Health Services. We will not distinguish between our prior and current segment name and will refer to our current segment name. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy-related transactions between the Evernorth Health Services and Cigna Healthcare segments.
The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income from operations as income before income taxes 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 the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results.
The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna 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.
The Company does not report total assets by segment because this is not a metric used to allocate resources or evaluate segment performance.
The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:
For the Years Ended December 31,
202220212020
(In millions)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Integration and transaction-related costs
 (Selling, general and administrative expenses)
$135 $103 $169 $71 $527 $404 
Charge for organizational efficiency plan
 (Selling, general and administrative expenses)
22 17 168 119 31 24 
(Benefits) charges associated with litigation matters
 (Selling, general and administrative expenses)
(28)(20)(27)(21)25 19 
(Gain) on sale of businesses(1,662)(1,332)— — (4,203)(3,217)
Debt extinguishment costs   141 110 199 151 
Risk corridors recovery
 (Selling, general and administrative expenses)
  — — (101)(76)
Contractual adjustment for a former client
 (Pharmacy revenues)
  — — (204)(155)
Total impact from special items$(1,533)$(1,232)$451 $279 $(3,726)$(2,850)
Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2022
Revenues from external customers$135,786 $41,737 $1,838 $ $179,361 
Intersegment revenues4,463 2,535  (6,998)
Net investment income
86 638 424 7 1,155 
Total revenues140,335 44,910 2,262 (6,991)180,516 
Net realized investment results from certain equity method investments
 126   126 
Adjusted revenues$140,335 $45,036 $2,262 $(6,991)$180,642 
Depreciation and amortization$2,283 $638 $6 $10 $2,937 
Income (loss) before income taxes
$4,421 $3,443 $2,084 $(1,595)$8,353 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(66)(4)(14) (84)
Net realized investment losses (1)
 530 91  621 
Amortization of acquired intangible assets1,772 103 1  1,876 
Special items
Integration and transaction-related costs   135 135 
Charge for organizational efficiency plan   22 22 
(Benefits) associated with litigation matters   (28)(28)
(Gain) on sale of businesses  (1,662) (1,662)
Pre-tax adjusted income (loss) from operations$6,127 $4,072 $500 $(1,466)$9,233 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2021
Revenues from external customers
$127,692 $41,378 $3,459 $— $172,529 
Intersegment revenues4,203 2,271 — (6,474)
Net investment income (loss)
17 1,003 530 (1)1,549 
Total revenues131,912 44,652 3,989 (6,475)174,078 
Net realized investment results from certain equity method investments— — — — — 
Adjusted revenues$131,912 $44,652 $3,989 $(6,475)$174,078 
Depreciation and amortization$2,316 $551 $52 $$2,923 
Income (loss) before income taxes
$3,908 $3,812 $852 $(1,790)$6,782 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(31)(3)(24)— (58)
Net realized investment losses (gains) (1)
(247)47 — (196)
Amortization of acquired intangible assets1,937 47 14 — 1,998 
Special items
Integration and transaction-related costs   169 169 
Charge for organizational efficiency plan   168 168 
(Benefits) associated with litigation matters —  (27)(27)
Debt extinguishment costs  —  141 141 
Pre-tax adjusted income (loss) from operations$5,818 $3,609 $889 $(1,339)$8,977 
(1) Includes the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2020
Revenues from external customers$112,647 $38,826 $7,684 $— $159,157 
Intersegment revenues3,655 1,966 23 (5,644)
Net investment income
32 473 739 — 1,244 
Total revenues116,334 41,265 8,446 (5,644)160,401 
Net realized investment results from certain equity method investments— (130)— — (130)
Special item related to contractual adjustment for a former client(204)— — — (204)
Adjusted revenues$116,130 $41,135 $8,446 $(5,644)$160,067 
Depreciation and amortization$2,248 $458 $71 $25 $2,802 
Income (loss) before income taxes
$3,684 $4,291 $5,227 $(2,334)$10,868 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(17)(1)(19)— (37)
Net realized investment (gains) (1)
(17)(202)(60)— (279)
Amortization of acquired intangible assets1,917 44 21 — 1,982 
Special items
Integration and transaction-related costs— — — 527 527 
Charge for organizational efficiency plan— — — 31 31 
Charges associated with litigation matters— — — 25 25 
(Gain) on sale of businesses— — (4,203)— (4,203)
Debt extinguishment costs — — — 199 199 
Risk corridors recovery — (101)— — (101)
Contractual adjustment for a former client (204)— — — (204)
Pre-tax adjusted income (loss) from operations$5,363 $4,031 $966 $(1,552)$8,808 
(1) Includes the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.
Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:
For the Years Ended December 31,
(In millions)202220212020
Products (Pharmacy revenues) (ASC 606)
Network revenues$64,946 $64,992 $56,365 
Home delivery and specialty revenues61,283 54,391 49,906 
Other revenues6,753 6,428 5,403 
Intercompany eliminations(4,416)(4,398)(3,905)
Total pharmacy revenues128,566 121,413 107,769 
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Commercial
Insured15,199 14,315 13,389 
Stop loss5,461 4,868 4,614 
Other1,418 1,290 1,135 
U.S. Government
Medicare Advantage7,896 8,362 7,565 
Medicare Part D1,224 1,499 1,593 
Other3,990 4,815 4,301 
International Health2,906 2,588 2,472 
Total Cigna Healthcare38,094 37,737 35,069 
Divested International businesses1,596 3,205 3,039 
Domestic disability, life and accident — 4,423 
Other224 221 124 
Intercompany eliminations1 (9)(28)
Total premiums39,915 41,154 42,627 
Services (Fees) (ASC 606)
Evernorth Health Services
7,234 6,070 4,611 
Cigna Healthcare
6,053 5,743 5,491 
Other Operations
9 19 116 
Other revenues167 197 254 
Intercompany eliminations(2,583)(2,067)(1,711)
Total fees and other revenues10,880 9,962 8,761 
Total revenues from external customers$179,361 $172,529 $159,157 
U.S. and foreign revenues from external customers are shown below. The Company's foreign revenues are generated by its foreign operating entities. In the periods shown, no single foreign country contributed more than 2% of consolidated revenues from external customers.
For the Years Ended December 31,
(In millions)202220212020
United States$174,539 $166,626 $154,042 
Foreign countries (1)
4,822 5,903 5,115 
Total$179,361 $172,529 $159,157 
(1) The divested International businesses as described in Note 4 comprised $1.6 billion, $3.2 billion and $3.1 billion in 2022, 2021 and 2020, respectively.
Revenues from U.S. Federal Government agencies, under a number of contracts, were 14% of consolidated revenues in 2022 and 2021 and 15% in 2020. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments.
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group
12 Months Ended
Dec. 31, 2022
Condensed Financial Information Disclosure [Abstract]  
Schedule I - Condensed Financial Information of The Cigna Group
THE CIGNA GROUP AND SUBSIDIARIES
SCHEDULE I
CONDENSED FINANCIAL INFORMATION OF THE CIGNA GROUP
(REGISTRANT)
STATEMENTS OF INCOME


 For the Years Ended December 31,
(In millions)202220212020
Revenues
Net investment income$5 $— $
Intercompany interest income478 471 475 
Total revenues483 471 476 
Operating expenses
Selling, general and administrative expenses2 
Total operating expenses2 
Income from operations481 463 472 
Interest and other expense
(1,215)(1,197)(1,324)
Intercompany interest expense
(147)(13)(48)
Debt extinguishment costs (131)(171)
Loss before income taxes(881)(878)(1,071)
Income tax benefits
(183)(180)(234)
Loss of Parent Company(698)(698)(837)
Equity in income of subsidiaries7,366 6,063 9,295 
Shareholders' net income6,668 5,365 8,458 
Shareholders' other comprehensive income (loss), net of tax
Net unrealized depreciation on securities and derivatives
(1,005)(215)(75)
Net translation gains (losses) of foreign currencies
74 (218)260 
Postretirement benefits liability adjustment420 410 (105)
Shareholders' other comprehensive (loss) income, net of tax
(511)(23)80 
Shareholders' comprehensive income$6,157 $5,342 $8,538 
 See Notes to Financial Statements on the following pages.
THE CIGNA GROUP AND SUBSIDIARIES
SCHEDULE I
CONDENSED FINANCIAL INFORMATION OF THE CIGNA GROUP
(REGISTRANT)
BALANCE SHEETS
 As of December 31,
(In millions)20222021
Assets  
Cash and cash equivalents$115 $33 
Short-term investments 99 
Other current assets6 
Total current assets121 141 
Intercompany receivable10,366 8,962 
Investments in subsidiaries70,877 70,896 
Other non-current assets99 17 
TOTAL ASSETS$81,463 $80,016 
Liabilities
Short-term debt$2,749 $2,453 
Other current liabilities1,296 775 
Total current liabilities4,045 3,228 
Intercompany payable5,705 
Other non-current liabilities26  
Long-term debt26,815 29,671 
TOTAL LIABILITIES36,591 32,904 
Shareholders' Equity
Common stock (shares issued, 398 and 394; authorized, 600)
4 
Additional paid-in capital30,233 29,574 
Accumulated other comprehensive loss(1,395)(884)
Retained earnings37,874 32,593 
Less treasury stock, at cost(21,844)(14,175)
TOTAL SHAREHOLDERS' EQUITY44,872 47,112 
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY$81,463 $80,016 
See Notes to Financial Statements on the following pages.
THE CIGNA GROUP AND SUBSIDIARIES
SCHEDULE I
CONDENSED FINANCIAL INFORMATION OF THE CIGNA GROUP
(REGISTRANT)
STATEMENTS OF CASH FLOWS
For the Years Ended December 31,
(In millions)202220212020
Cash Flows from Operating Activities   
Shareholders' net income$6,668 $5,365 $8,458 
Adjustments to reconcile shareholders' net income
to net cash provided by operating activities
Equity in income of subsidiaries(7,366)(6,063)(9,295)
Debt extinguishment costs 131 171 
Dividends received from subsidiaries2,085 2,751 8,627 
Other liabilities5 184 112 
Other, net269 414 500 
NET CASH PROVIDED BY OPERATING ACTIVITIES
1,661 2,782 8,573 
Cash Flows from Investing Activities
Net change in loans due from affiliates
(901)(1,007)(265)
Net proceeds from short-term investments sold (purchased)
99 (50)(19)
NET CASH USED IN INVESTING ACTIVITIES
(802)(1,057)(284)
Cash Flows from Financing Activities
Net change in amounts due to affiliates10,392 2,062 2,262 
Net change in commercial paper(2,027)997 86 
Payments for debt extinguishment (126)(181)
Repayment of long-term debt(430)(4,199)(5,996)
Net proceeds on issuance of long-term debt 4,260 3,465 
Issuance of common stock389 326 376 
Common dividends paid(1,384)(1,341)(15)
Repurchase of common stock(7,607)(7,742)(4,042)
Tax withholding on stock compensation and other(73)(86)(87)
NET CASH USED IN FINANCING ACTIVITIES
(740)(5,849)(4,132)
Net increase (decrease) in cash,cash equivalents and restricted cash
119 (4,124)4,157 
Cash and cash equivalents, beginning of year33 4,157 — 
Cash, cash equivalents and restricted cash, end of year (1)
$152 $33 $4,157 
(1) Includes restricted cash reported in Other non-current assets as of December 31, 2022.


See Notes to Financial Statements on the following pages.
THE CIGNA GROUP AND SUBSIDIARIES
SCHEDULE I
CONDENSED FINANCIAL INFORMATION OF THE CIGNA GROUP
(REGISTRANT)
NOTES TO CONDENSED FINANCIAL STATEMENTS
The accompanying condensed financial statements should be read in conjunction with the Consolidated Financial Statements and the accompanying notes thereto contained in this Annual Report on Form 10-K ("Form 10-K").
Note 1 — For purposes of these condensed financial statements, The Cigna Group's (the "Company") wholly-owned and majority-owned subsidiaries are recorded using the equity method of accounting.
Cigna Holding Company (formerly Cigna Corporation) was incorporated in Delaware in 1981. Halfmoon Parent, Inc. was incorporated in Delaware in March 2018. Halfmoon Parent, Inc. was renamed Cigna Corporation and Cigna Holding Company became its subsidiary concurrent with the consummation of the combination with Express Scripts on December 20, 2018. Cigna Corporation was renamed The Cigna Group in February 2023.
Note 2 — See Note 7 – Debt included in Part II, Item 8 of this Form 10-K for a description of the short-term and long-term debt obligations of The Cigna Group and its subsidiaries.
Short-term and Credit Facilities Debt
Revolving Credit Agreements. Our revolving credit agreements provide us with the ability to borrow amounts for general corporate purposes, including for the purpose of providing liquidity support if necessary under our commercial paper program discussed below. As of December 31, 2022, there were no outstanding balances under these revolving credit agreements.
In April 2022, The Cigna Group entered into the following revolving credit agreements (the "Credit Agreements"):
a $3.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2027 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $3.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.
a $1.0 billion three-year revolving credit agreement that will mature in April 2025 with an option to extend the maturity date for additional one-year periods, subject to consent of the banks. The Company can borrow up to $1.0 billion under the credit agreement for general corporate purposes.
a $1.0 billion 364-day revolving credit agreement that will mature in April 2023. The Company can borrow up to $1.0 billion under the credit agreement for general corporate purposes. This agreement includes the option to "term out" any revolving loans that are outstanding at maturity by converting them into a term loan maturing on the one-year anniversary of conversion.
Each of the Credit Agreements include an option to increase commitments in an aggregate amount of up to $1.5 billion across all three facilities for a maximum total commitment of $6.5 billion. The Credit Agreements allow for borrowings at either a base rate or an adjusted term Secured Overnight Funding Rate ("SOFR") plus, in each case, an applicable margin based on the Company's senior unsecured credit ratings.

Each of the three facilities is diversified among 22 banks. Each facility also contains customary covenants and restrictions, including a financial covenant that the Company's leverage ratio, as defined in the Credit Agreements, may not exceed 60%, subject to certain exceptions upon the consummation of an acquisition.

The Credit Agreements replaced a prior $3.0 billion five-year revolving credit and letter of credit agreement maturing on April 2026, a $1.0 billion three-year revolving credit agreement maturing on April 2024 and a $1.0 billion 364-day revolving credit agreement maturing in April 2022.

Commercial Paper. Under our commercial paper program, we may issue short-term, unsecured commercial paper notes privately placed on a discounted basis through certain broker-dealers at any time not to exceed an aggregate amount of $5.0 billion. Amounts available under the program may be borrowed, repaid and re-borrowed from time to time. The net proceeds of issuances have been and are expected to be used for general corporate purposes. There was no commercial paper outstanding balance as of December 31, 2022.
Long-Term Debt
Debt Issuance and Redemption. The Company did not enter into any debt issuances or redemptions in 2022. In order to decrease future interest expense, mitigate future refinancing risk and raise proceeds for general corporate purposes, the Company entered into the following transactions during 2021:
Debt issuance: On March 3, 2021, the Company issued $4.3 billion of new senior notes. The proceeds of this issuance were mainly used to redeem outstanding debt securities. The remaining proceeds were used primarily for general corporate purposes.

Debt redemption: During 2021, the Company completed the redemption of a total of $4.2 billion in aggregate principal amount of certain of its outstanding debt securities. The Company recorded a pre-tax loss of $131 million ($101 million after-tax), consisting primarily of premium payments.
Maturities of the Company's long-term debt are as follows:
(In millions) 
2023$2,754 
2024$1,214 
2025$2,957 
2026$2,034 
2027$2,056 
Maturities after 2027$18,891 
Debt Covenants. The Company was in compliance with its debt covenants as of December 31, 2022.

Note 3 — The Company's intercompany receivables consist primarily of net intercompany loan amounts due from Evernorth Health, Inc. of $8.3 billion as of December 31, 2022 and $7.8 billion as of December 31, 2021. Interest income on the loan receivable was accrued at an average rate of 4.65% in 2022.
The Company's intercompany payables consist primarily of net intercompany loan borrowing from three indirect wholly-owned subsidiaries as of December 31, 2022. Interest expense on the loan payable was accrued at an average rate of 2.82% in 2022.
Note 4 — The Company guaranteed approximately $730 million of payment obligations primarily related to certain indirect wholly-owned subsidiaries. There were no liabilities required for these guarantees as of December 31, 2022.
v3.22.4
Schedule II - Valuation and Qualifying Accounts and Reserves
12 Months Ended
Dec. 31, 2022
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]  
Schedule II - Valuation and Qualifying Accounts and Reserves THE CIGNA GROUP AND SUBSIDIARIES
SCHEDULE II
VALUATION AND QUALIFYING ACCOUNTS AND RESERVES
(In millions)Balance at beginning of yearCharged (Credited) to costs and expensesCharged (Credited) to other accountsOther deductionsBalance at end of year
Description
2022     
Investment asset valuation reserves
Available-for-sale debt securities$23 $43 $ $(22)$44 
Commercial mortgage loans$6 $15 $ $ $21 
Accounts receivable, net$126 $99 $ $(65)$160 
Deferred tax asset valuation allowance$246 $(13)$(25)$ $208 
Reinsurance recoverables $30 $7 $ $ $37 
2021
Investment asset valuation reserves
Available-for-sale debt securities$26 $29 $— $(32)$23 
Commercial mortgage loans$$— $— $— $
Accounts receivable, net$156 $54 $— $(84)$126 
Deferred tax asset valuation allowance $207 $23 $16 $— $246 
Reinsurance recoverables$32 $(2)$— $— $30 
2020
Investment asset valuation reserves
Available-for-sale debt securities$— $82 $— $(56)$26 
Commercial mortgage loans (1)
$— $(1)$$— $
Accounts receivable, net$252 $(50)$(12)$(34)$156 
Deferred tax asset valuation allowance $196 $10 $$— $207 
Reinsurance recoverables (2)
$$(1)$31 $— $32 
(1) The Company recorded an additional allowance of $7 million on January 1, 2020 upon the adoption of ASU 2016-13.
(2) The Company recorded an additional allowance of $31 million on January 1, 2020 upon the adoption of ASU 2016-13.
v3.22.4
Summary of Significant Accounting Policies (Policies)
12 Months Ended
Dec. 31, 2022
Accounting Policies [Abstract]  
Basis of Presentation
Basis of Presentation
The Consolidated Financial Statements include the accounts of The Cigna Group and its consolidated subsidiaries. Intercompany transactions and accounts have been eliminated in consolidation. These Consolidated Financial Statements were prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP"). Certain amounts in prior years have been reclassified to conform to the current year presentation.
Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment and receivable valuations, interest rates and other factors. Significant estimates are discussed throughout these Notes; however, actual results could differ from those estimates. The impact of a change in estimate is generally included in earnings in the period of adjustment.
Recent Accounting Pronouncements, Recently Adopted Accounting Guidance and Accounting Guidance Not Yet Adopted
Recent Accounting Pronouncements
There were no new accounting standards adopted during the year ended December 31, 2022 that had a material impact on our Consolidated Financial Statements.
Accounting Guidance Not Yet Adopted
Targeted Improvements to the Accounting for Long-Duration Contracts (ASU 2018-12) and related amendments ("LDTI")
Effective date of January 1, 2023 for The Cigna Group and requires the following key provisions (for insurance entities that issue long-duration contracts):

Changes to the measurement of the future policy benefits liability for traditional and limited-pay insurance contracts:
Assumptions used to measure cash flows (such as mortality, morbidity and lapse assumptions) to be updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.
Discount rate assumptions to be updated quarterly based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed-income instrument"), with any changes reflected in other comprehensive income. The upper-medium grade fixed-income instrument yield is interpreted to mean A-rated.
Deferred policy acquisition costs ("DAC") related to long-duration insurance contracts to be amortized on a constant-level basis over the expected term of the related contracts. Other related deferred or capitalized balances (such as unearned revenue liability and value of business acquired) may use this simplified amortization method.
Market risk benefits (defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk) to be measured at fair value, with changes in fair value recognized in net income each period, except for the effect of changes in the insurance entity's credit risk to be recognized in other comprehensive income.
Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, separate account liabilities and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.
Transition methods at adoption vary:
Changes to the liability for future policy benefits and DAC to use a modified retrospective approach applied to all outstanding contracts on the basis of their existing carrying amounts as of the beginning of the earliest period presented, with an option to elect a full retrospective transition under certain criteria. Remeasuring the future policy benefits liability for the discount rate to be recorded through accumulated other comprehensive loss at transition.
Market risk benefits to be transitioned retrospectively and measured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value to be recognized in the opening balance of retained earnings, excluding the effect of credit risk changes that are to be recognized in accumulated other comprehensive loss.
Expected effects:
The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.
The Company developed a cross-functional implementation project plan and executed on the necessary changes to our systems, processes and controls.
The Company adopted the standard on January 1, 2023, using the modified retrospective transition method for changes to the liability for future policy benefits and DAC. The impact of adoption was not material to Shareholders' equity and did not result in a material restatement of prior periods.
It is possible that our income recognition pattern could change on a prospective basis for several reasons:
Applying periodic assumption updates, versus the current locked-in model, may change our timing of profit or loss recognition.
DAC amortization will be on a constant level basis over the expected term of the related contracts and no longer tied to the emergence of profit on such contracts.
Features, such as the Company's GMDB product, that provide market-risk benefits are not currently measured at fair value, so these liabilities and related reinsurance recoverables will become subject to market sensitivity, notably to interest rates.
In December 2022, the Financial Accounting Standards Board ("FASB") published Accounting Standards Update (ASU) 2022-05, which simplifies the retrospective adoption of LDTI. The ASU permits companies to make an accounting policy election to exclude contracts that are sold and removed from the balance sheet prior to the effective date of the standard from the retrospective adoption of LDTI. The Cigna Group made this policy election for the contracts sold in the Chubb transaction and our divested interest in a joint venture in Türkiye.
Cash and Cash Equivalents Cash and cash equivalents are carried at cost that approximates fair value. Cash equivalents consist of short-term investments with maturities of three months or less from the time of purchase. The Company reclassifies cash overdraft positions to liabilities when the legal right of offset does not exist.
Inventories Inventories consist of prescription drugs and medical supplies and are stated at the lower of first-in-first-out cost or net realizable value.
Deferred Policy Acquisition Costs
Costs eligible for deferral, recorded within Other assets (non-current), include incremental, direct costs of acquiring new or renewal insurance and investment contracts and other costs directly related to successful contract acquisition. Examples of deferrable costs include commissions, sales compensation and benefits, policy issuance and underwriting costs. The Company records acquisition costs differently depending on the product line. Acquisition costs for:
Supplemental health, life and accident insurance products (primarily individual products) that comprise the majority of the Company's deferred policy acquisition costs and group health and accident insurance products are deferred and amortized, generally in proportion to the ratio of periodic revenue to the estimated total revenues over the contract periods.
Universal life products are deferred and amortized in proportion to the present value of total estimated gross profits over the expected lives of the contracts.
Other products are expensed as incurred.
Deferred policy acquisition costs also include the value of business acquired ("VOBA") for certain acquisitions with material long-duration insurance contracts. The Company recorded amortization of deferred policy acquisition costs of $319 million in 2022, $478 million in 2021 and $502 million in 2020 primarily in Selling, general and administrative expenses.
Each year, deferred policy acquisition costs are tested for recoverability. For universal life and other individual products, management estimates the present value of future revenues less expected payments. For group health and accident insurance products, management estimates the sum of unearned premiums and anticipated net investment income less future expected claims and related costs. If management's estimates of these sums are less than the deferred costs, the Company reduces deferred policy acquisition costs and records an additional expense.
Other Assets (Current and Non-Current) Other current assets consist primarily of prepaid expenses, accrued investment income, the current portion of reinsurance recoverables and income tax receivables. Other assets (non-current) consist primarily of the carrying value of our equity-method investments in business-related joint ventures in China, India, the U.S. and other foreign jurisdictions. Earnings or losses from these equity-method investments in joint ventures are recorded in Fees and other revenues. See Note 14 for additional information on unconsolidated subsidiaries. Additionally, Other assets (non-current) include deferred policy acquisition costs, operating lease right-of-use assets, GMIB assets, overfunded pension obligations (see Note 17) and various other insurance-related assets. See Note 10 for the Company's accounting policy for GMIB assets and Note 20 for the Company's accounting policy related to leases.
Redeemable Noncontrolling Interest Redeemable noncontrolling interests in our Consolidated Balance Sheets represents the noncontrolling shareholders' preferred and common stock interests of the Company's consolidated less than fully owned subsidiaries. Those shareholders may choose to require the Company to purchase their equity interest. For certain entities, we may also have the right to require those shareholders to sell their equity interest to us. As these redeemable noncontrolling interests provide for redemption features not solely within our control, we classify the redeemable noncontrolling interests outside of permanent equity. The noncontrolling interest was initially recorded at fair value. In subsequent reporting periods, the values are adjusted to reflect the earnings, losses and distributions attributable to the noncontrolling interest. When a shareholder's right to require the Company to purchase its equity interest is exercisable, the redeemable noncontrolling interest is recorded at estimated redemption value. When the estimated redemption value for a redeemable noncontrolling interest exceeds its initial carrying value, an adjustment to increase or decrease the redeemable noncontrolling interest is recorded with an offsetting adjustment to Retained earnings or Additional paid-in capital in the absence of Retained earnings. When an adjustment is made to the carrying value of the redeemable noncontrolling interest, the calculation of shareholders' net income per share will be adjusted if the redemption value exceeds fair value.
Accrued Expenses and Other Current and Non-Current Liabilities
Accrued expenses and other liabilities (current) primarily includes financial and performance guarantee liabilities under pharmacy contracts (see section H), management compensation and various insurance-related liabilities, including experience-rated refunds, reinsurance contracts and the risk adjustment and minimum medical loss ratio rebate accruals under The Patient Protection and Affordable Care Act (the "ACA"). Other non-current liabilities primarily include uncertain tax positions (see Note 22), GMIB contract liabilities (see Note 10), lease liabilities (see Note 20), self-insured exposures not expected to be settled within one year and underfunded pension obligations (see Note 17).
The Company accrues for legal and regulatory matters when a loss contingency is both probable and estimable. The estimated loss is generally recorded in Selling, general and administrative expenses and represents the Company's best estimate of the loss contingency. If the loss estimate is a range, the Company accrues the minimum amount in the range if no amount is better than any other estimated amount in the range. Legal costs to defend the Company's litigation and arbitration matters are expensed as incurred in cases that the Company cannot reasonably estimate the ultimate cost to defend. If the Company can reasonably estimate the cost to defend, a liability for these costs is accrued when the claim is reported. Litigation and legal or regulatory matters that the Company has identified with a reasonable possibility of material loss are described in Note 23.
Translation of Foreign Currencies The Company generally conducts its international business through foreign operating entities that maintain assets and liabilities in local currencies that are their functional currencies. The Company uses exchange rates as of the balance sheet date to translate assets and liabilities into U.S. dollars. Translation gains or losses on functional currencies, net of applicable taxes, are recorded in Accumulated other comprehensive loss. The Company uses average monthly exchange rates during the year to translate revenues and expenses into U.S. dollars.
Revenue Recognition
Pharmacy revenues. Pharmacy revenues are primarily derived from providing pharmacy benefit management services to clients and customers. Pharmacy revenues are recognized when control of the promised goods or services is transferred to clients and customers, in an amount that reflects the consideration the Company expects to receive for those goods or services.
The Company provides or makes available various services supporting benefit management and claims administration and is generally obligated to provide prescription drugs to clients' members using multiple distribution methods including retail networks, home delivery and specialty pharmacies. These goods and services are integrated into a single performance obligation to process claims, dispense prescription drugs and provide other services over the contract period (generally three years). This performance obligation is satisfied as the business stands ready to fulfill its obligation.
Revenues for dispensing prescription drugs through retail pharmacies are reported gross and consist of the prescription price (ingredient cost and dispensing fee) contracted with clients, including the customer copayment and any associated fees for services, because the Company acts as the principal in these arrangements. When a prescription is presented to a retail network pharmacy, the Company is solely responsible for customer eligibility, drug utilization review, drug-to-drug interaction review, any required clinical intervention, plan provision information, payment to the pharmacy and client billing. These revenues are recognized based on the full prescription price when the pharmacy claim is processed and approved for payment. The Company also provides benefit design and formulary consultation services to clients and negotiates separate contractual relationships with clients and network pharmacies. These factors indicate that the Company has control over these transactions until the prescription is processed. Revenues are billed, due and recognized at contract rates either on a periodic basis or as services are provided (such as based on volume of claims processed). This recognition pattern aligns with the benefits from services provided.
Home delivery and specialty pharmacy revenues are due and recognized as each prescription is shipped, net of reserves for discounts and contractual allowances estimated based on historical experience. Any differences between estimates and actual collections are reflected in Pharmacy revenues when payments are received. Historically, adjustments to original estimates and returns have not been material. The Company has elected the practical expedient to account for shipping and handling as a fulfillment activity.
We may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid at the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. The liability for these financial and performance guarantees was $1.3 billion as of December 31, 2022 and $1.1 billion as of December 31, 2021.
The Company administers programs through which we may receive rebates and other vendor consideration from pharmaceutical manufacturers. The amounts of such rebates or other vendor consideration shared with pharmacy benefit management services clients vary based on the contractual arrangement with the client and in some cases the type of consideration received from the pharmaceutical manufacturer. Rebates and other vendor consideration payable to pharmacy benefit management services clients are recorded as a reduction of Pharmacy revenues. Estimated amounts payable to clients are based on contractual sharing arrangements between the Company and the client and these amounts are adjusted when amounts are collected from pharmaceutical manufacturers in accordance with the contractual arrangement between the Company and the client. Historically, these adjustments have not been material.
In retail, home delivery and specialty transactions, amounts may be collected from third-party payors. These are billed and collected in accordance with the Company's standard accounts receivable collection procedures.
Other pharmacy service revenues are earned by distributing specialty pharmaceuticals and medical supplies to providers, clinics and hospitals. These revenues are billed, due and recognized at contracted rates as prescriptions and supplies are shipped and services are provided.
Pharmacy costs. Pharmacy costs include the cost of prescriptions sold, network pharmacy claim costs and copayments. Also included are direct costs of dispensing prescriptions including supplies, shipping and handling and direct costs associated with clinical programs, such as drug utilization management and medication adherence counseling. Home delivery and specialty pharmacy costs are recognized when the drug is shipped and retail network costs are recognized when the drug is processed and approved for payment. Rebates and other vendor consideration received when providing pharmacy benefit management services are recorded as a reduction of pharmacy costs. Rebates are recognized as prescriptions are shipped or processed and approved for payment. Historically, the effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected, net of contractual allowances, has not been material. The Company maintains reimbursement guarantees with certain retail network pharmacies. For each such guarantee, the Company records a pharmacy and other service costs payable or prepaid asset for applicable retail network claims based on our actual performance throughout the period against the contractual reimbursement rate. The Company's contracts with certain retail pharmacies give the Company the right to adjust reimbursement rates during the annual guarantee period.
Other. Incremental costs of obtaining service and pharmacy contracts for short-term arrangements are expensed as incurred.
I.Premiums and Related Expenses
Premiums for short-duration group health, accident and life insurance and managed care coverages are recognized as revenue on a pro rata basis over the contract period. Benefits and expenses are recognized when incurred and, for our Cigna Healthcare business, are presented net of pharmaceutical manufacturer rebates. For experience-rated contracts, premium revenue includes an adjustment for experience-rated refunds based on contract terms and calculated using the customer's experience (including estimates of incurred but not reported claims).
Premiums received for the Company's Medicare Advantage plans, Medicare Part D products and Individual and Family Plans from the Centers for Medicare and Medicaid Services ("CMS") and customers are recognized as revenue ratably over the contract period.
CMS provides risk-adjusted premium payments for Medicare Advantage Plans and Medicare Part D products based on our customer demographics and medical diagnoses, which may change from period to period based on the underlying health of our customers. The Company recognizes changes to risk-adjusted premiums as revenue when the amounts are determinable and collection is reasonably assured. Revenue adjustments are generally settled semi-annually with CMS. The final revenue adjustment is generally settled with CMS in the year following the contract year.
Medicare Part D premiums include payments from CMS for risk-sharing adjustments that are estimated quarterly based on claim experience by comparing actual incurred prescription drug costs to the estimated costs submitted in the original contracts. These
adjustments may result in more or less revenue from CMS. Final revenue adjustments generally occur in the year following the contract year.
The ACA prescribed a risk-adjustment program to mitigate the risk for participating health insurance companies selling coverage on the public exchanges. The risk-adjustment program reallocates funds from insurers with lower risk populations to insurers with higher risk populations based on the relative risk scores of participants. We estimate our receivable or payable based on the risk of our customers compared to the risk of other customers in the same state and market, considering data obtained from industry studies and the United States Department of Health and Human Services ("HHS"). Receivables or payables are recorded as adjustments to premium revenue based on our year-to-date experience when the amounts are reasonably estimable and collection is reasonably assured. Final revenue adjustments are determined by HHS in the year following the policy year.
Premium revenue may also include an adjustment to reflect the estimated effect of rebates due to customers under medical loss ratio provisions of the ACA. These rebate liabilities are settled in the subsequent year.
Premiums for long-duration insurance contracts, including individual life, accident and supplemental health insurance and annuity products, and excluding universal life and investment-related products, are recognized as revenue when due. Benefits and expenses are matched with premiums.
Revenue for universal life products is recognized as follows:
Investment income on assets supporting universal life products is recognized in Net investment income as earned.
Charges for mortality, administration and policy surrender are recognized in Premiums as earned. Administrative fees are considered earned when services are provided.
Benefits and expenses for universal life products consist of benefit claims in excess of policyholder account balances and income earned by policyholders. Expenses are recognized when claims are incurred and income is credited to policyholders in accordance with contract provisions.
The unrecognized portion of premiums received is recorded as unearned premiums included in Insurance and contractholder liabilities (current and non-current) (see Note 9 for further information).
J.Fees and Related Expenses
The majority of the Company's service fees are derived from administrative services only ("ASO") arrangements, fee-for-service clinical solutions, Wholesale Marketplace Drug Formulary Management services, health benefit management services and administration of services to specialty pharmacy manufacturers.
ASO arrangements allow plan sponsors to self-fund claims and assume the risk of medical or other benefit costs. Most of the Company's ASO arrangements are for medical and specialty services, including pharmacy benefits. Generally, the Company's ASO arrangements are short-term. Contract modifications typically occur on renewal and are prospective in nature.
In return for fees from these clients, the Company provides access to our participating provider networks and other services supporting benefit management, including claims administration, behavioral health services, disease management, utilization management and cost containment programs. In general, the Company considers these services to be a combined performance obligation to provide cost effective administration of plan benefits over the contract period. Fees are billed, due and recognized monthly at contracted rates based on current membership or utilization. This recognition pattern aligns with the benefits from services provided to clients. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income.
The Company may also provide performance guarantees that provide potential refunds to clients if certain service standards, clinical outcomes or financial metrics are not met. If these standards, outcomes and metrics are not met, the Company may be financially at risk up to a stated percentage of the contracted fee or a stated dollar amount. The Company defers revenue by recording a liability for estimated payouts associated with these guarantees within Accrued expenses and other liabilities. The amount of revenue deferred is estimated for each type of guarantee using either a most likely amount or expected value method depending on the nature of the guarantee and the information available to estimate refunds. Estimates are refined each reporting period as additional information on the Company's performance becomes available and upon final reconciliation and settlement following the guarantee period. Amounts accrued and paid for these performance guarantees during the reporting periods were not material.
Expenses associated with administrative programs and services are recognized as incurred in Selling, general and administrative expenses.
The Company also earns revenue, as part of its integrated pharmacy benefits performance obligation, by offering fee-for-service clinical solutions to our clients, such as drug utilization management and medication adherence counseling. These clinical programs help clients to drive better health outcomes at a lower cost by identifying and addressing potentially unsafe or wasteful prescribing, dispensing and utilization of prescription drugs and communicating with, or supporting communications with physicians, pharmacies and patients. Fees are billed, due and recognized at contracted rates either on a periodic basis or as services are provided. This recognition pattern aligns with the benefits from services provided. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded as incurred in Selling, general and administrative expenses.
The Company earns fees from our Wholesale Marketplace Drug Formulary Management services. These services include either our drug formulary administrative service arrangements or our formulary processing arrangements. Drug formulary administrative services may include formulary consultation, administration of rebate contracts, rebate submission, collection from drug manufacturers and the distribution of rebates to clients. Services may also include facilitating audits of data submissions and reporting of rebates to clients. Clients agree to pay administrative fees that are billed, due and recognized at contracted rates as services are performed. These revenues are reported gross in Fees and other revenues and associated costs are reported in Pharmacy and other service costs in the Consolidated Statements of Income. For certain other clients in our formulary processing arrangements, the Company does not control the right to retain rebates before they are transferred to the client for services performed. Clients agree to allow the Company to retain a portion of each rebate collected in exchange for formulary processing services provided. These drug formulary service and administrative fee revenues are reported net in Fees and other revenues in the Consolidated Statements of Income. Revenue is recognized as rebates are processed.
The Company also earns fees by providing health benefit management solutions that drive cost reductions and improve quality outcomes. Clients are primarily sponsors of health benefit plans and fees may be stated as a per-member-per-month fee or as a per-claim fee. The Company considers the services to be a single performance obligation to stand ready to provide utilization management services over the contract period (generally three years). In certain arrangements, the Company assumes the financial obligation for third-party provider costs for medical services provided to the health plan's customers. Fees are recorded gross in Fees and other revenues in the Consolidated Statements of Income because the Company is acting as a principal in arranging for and controlling the services provided by third-party network providers. Contractual fees vary based on enrollment and provider costs and are billed, due and recognized monthly. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded in Selling, general and administrative expenses as incurred.
Certain health benefit management contracts require the Company to share the results of medical cost experience that differ from specified targets. This variable consideration is estimated at contract inception and adjusted through the contract period. The estimated profits and costs are recognized net in Fees and other revenues.
The Company also earns other service fees related to administrating services to specialty pharmacy manufacturers that are recorded in Fees and other revenues in the Consolidated Statements of Income. These revenues are billed, due and recognized at contracted rates as services are provided.
Cost of Goods and Service
Pharmacy revenues. Pharmacy revenues are primarily derived from providing pharmacy benefit management services to clients and customers. Pharmacy revenues are recognized when control of the promised goods or services is transferred to clients and customers, in an amount that reflects the consideration the Company expects to receive for those goods or services.
The Company provides or makes available various services supporting benefit management and claims administration and is generally obligated to provide prescription drugs to clients' members using multiple distribution methods including retail networks, home delivery and specialty pharmacies. These goods and services are integrated into a single performance obligation to process claims, dispense prescription drugs and provide other services over the contract period (generally three years). This performance obligation is satisfied as the business stands ready to fulfill its obligation.
Revenues for dispensing prescription drugs through retail pharmacies are reported gross and consist of the prescription price (ingredient cost and dispensing fee) contracted with clients, including the customer copayment and any associated fees for services, because the Company acts as the principal in these arrangements. When a prescription is presented to a retail network pharmacy, the Company is solely responsible for customer eligibility, drug utilization review, drug-to-drug interaction review, any required clinical intervention, plan provision information, payment to the pharmacy and client billing. These revenues are recognized based on the full prescription price when the pharmacy claim is processed and approved for payment. The Company also provides benefit design and formulary consultation services to clients and negotiates separate contractual relationships with clients and network pharmacies. These factors indicate that the Company has control over these transactions until the prescription is processed. Revenues are billed, due and recognized at contract rates either on a periodic basis or as services are provided (such as based on volume of claims processed). This recognition pattern aligns with the benefits from services provided.
Home delivery and specialty pharmacy revenues are due and recognized as each prescription is shipped, net of reserves for discounts and contractual allowances estimated based on historical experience. Any differences between estimates and actual collections are reflected in Pharmacy revenues when payments are received. Historically, adjustments to original estimates and returns have not been material. The Company has elected the practical expedient to account for shipping and handling as a fulfillment activity.
We may also provide certain financial and performance guarantees, including a minimum level of discounts a client may receive, generic utilization rates and various service levels. Clients may be entitled to receive compensation if we fail to meet the guarantees. Actual performance is compared to the contractual guarantee for each measure throughout the period and the Company defers revenue for any estimated payouts within Accrued expenses and other liabilities (current). These estimates are adjusted and paid at the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. The liability for these financial and performance guarantees was $1.3 billion as of December 31, 2022 and $1.1 billion as of December 31, 2021.
The Company administers programs through which we may receive rebates and other vendor consideration from pharmaceutical manufacturers. The amounts of such rebates or other vendor consideration shared with pharmacy benefit management services clients vary based on the contractual arrangement with the client and in some cases the type of consideration received from the pharmaceutical manufacturer. Rebates and other vendor consideration payable to pharmacy benefit management services clients are recorded as a reduction of Pharmacy revenues. Estimated amounts payable to clients are based on contractual sharing arrangements between the Company and the client and these amounts are adjusted when amounts are collected from pharmaceutical manufacturers in accordance with the contractual arrangement between the Company and the client. Historically, these adjustments have not been material.
In retail, home delivery and specialty transactions, amounts may be collected from third-party payors. These are billed and collected in accordance with the Company's standard accounts receivable collection procedures.
Other pharmacy service revenues are earned by distributing specialty pharmaceuticals and medical supplies to providers, clinics and hospitals. These revenues are billed, due and recognized at contracted rates as prescriptions and supplies are shipped and services are provided.
Pharmacy costs. Pharmacy costs include the cost of prescriptions sold, network pharmacy claim costs and copayments. Also included are direct costs of dispensing prescriptions including supplies, shipping and handling and direct costs associated with clinical programs, such as drug utilization management and medication adherence counseling. Home delivery and specialty pharmacy costs are recognized when the drug is shipped and retail network costs are recognized when the drug is processed and approved for payment. Rebates and other vendor consideration received when providing pharmacy benefit management services are recorded as a reduction of pharmacy costs. Rebates are recognized as prescriptions are shipped or processed and approved for payment. Historically, the effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected, net of contractual allowances, has not been material. The Company maintains reimbursement guarantees with certain retail network pharmacies. For each such guarantee, the Company records a pharmacy and other service costs payable or prepaid asset for applicable retail network claims based on our actual performance throughout the period against the contractual reimbursement rate. The Company's contracts with certain retail pharmacies give the Company the right to adjust reimbursement rates during the annual guarantee period.
Other. Incremental costs of obtaining service and pharmacy contracts for short-term arrangements are expensed as incurred.
I.Premiums and Related Expenses
Premiums for short-duration group health, accident and life insurance and managed care coverages are recognized as revenue on a pro rata basis over the contract period. Benefits and expenses are recognized when incurred and, for our Cigna Healthcare business, are presented net of pharmaceutical manufacturer rebates. For experience-rated contracts, premium revenue includes an adjustment for experience-rated refunds based on contract terms and calculated using the customer's experience (including estimates of incurred but not reported claims).
Premiums received for the Company's Medicare Advantage plans, Medicare Part D products and Individual and Family Plans from the Centers for Medicare and Medicaid Services ("CMS") and customers are recognized as revenue ratably over the contract period.
CMS provides risk-adjusted premium payments for Medicare Advantage Plans and Medicare Part D products based on our customer demographics and medical diagnoses, which may change from period to period based on the underlying health of our customers. The Company recognizes changes to risk-adjusted premiums as revenue when the amounts are determinable and collection is reasonably assured. Revenue adjustments are generally settled semi-annually with CMS. The final revenue adjustment is generally settled with CMS in the year following the contract year.
Medicare Part D premiums include payments from CMS for risk-sharing adjustments that are estimated quarterly based on claim experience by comparing actual incurred prescription drug costs to the estimated costs submitted in the original contracts. These
adjustments may result in more or less revenue from CMS. Final revenue adjustments generally occur in the year following the contract year.
The ACA prescribed a risk-adjustment program to mitigate the risk for participating health insurance companies selling coverage on the public exchanges. The risk-adjustment program reallocates funds from insurers with lower risk populations to insurers with higher risk populations based on the relative risk scores of participants. We estimate our receivable or payable based on the risk of our customers compared to the risk of other customers in the same state and market, considering data obtained from industry studies and the United States Department of Health and Human Services ("HHS"). Receivables or payables are recorded as adjustments to premium revenue based on our year-to-date experience when the amounts are reasonably estimable and collection is reasonably assured. Final revenue adjustments are determined by HHS in the year following the policy year.
Premium revenue may also include an adjustment to reflect the estimated effect of rebates due to customers under medical loss ratio provisions of the ACA. These rebate liabilities are settled in the subsequent year.
Premiums for long-duration insurance contracts, including individual life, accident and supplemental health insurance and annuity products, and excluding universal life and investment-related products, are recognized as revenue when due. Benefits and expenses are matched with premiums.
Revenue for universal life products is recognized as follows:
Investment income on assets supporting universal life products is recognized in Net investment income as earned.
Charges for mortality, administration and policy surrender are recognized in Premiums as earned. Administrative fees are considered earned when services are provided.
Benefits and expenses for universal life products consist of benefit claims in excess of policyholder account balances and income earned by policyholders. Expenses are recognized when claims are incurred and income is credited to policyholders in accordance with contract provisions.
The unrecognized portion of premiums received is recorded as unearned premiums included in Insurance and contractholder liabilities (current and non-current) (see Note 9 for further information).
J.Fees and Related Expenses
The majority of the Company's service fees are derived from administrative services only ("ASO") arrangements, fee-for-service clinical solutions, Wholesale Marketplace Drug Formulary Management services, health benefit management services and administration of services to specialty pharmacy manufacturers.
ASO arrangements allow plan sponsors to self-fund claims and assume the risk of medical or other benefit costs. Most of the Company's ASO arrangements are for medical and specialty services, including pharmacy benefits. Generally, the Company's ASO arrangements are short-term. Contract modifications typically occur on renewal and are prospective in nature.
In return for fees from these clients, the Company provides access to our participating provider networks and other services supporting benefit management, including claims administration, behavioral health services, disease management, utilization management and cost containment programs. In general, the Company considers these services to be a combined performance obligation to provide cost effective administration of plan benefits over the contract period. Fees are billed, due and recognized monthly at contracted rates based on current membership or utilization. This recognition pattern aligns with the benefits from services provided to clients. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income.
The Company may also provide performance guarantees that provide potential refunds to clients if certain service standards, clinical outcomes or financial metrics are not met. If these standards, outcomes and metrics are not met, the Company may be financially at risk up to a stated percentage of the contracted fee or a stated dollar amount. The Company defers revenue by recording a liability for estimated payouts associated with these guarantees within Accrued expenses and other liabilities. The amount of revenue deferred is estimated for each type of guarantee using either a most likely amount or expected value method depending on the nature of the guarantee and the information available to estimate refunds. Estimates are refined each reporting period as additional information on the Company's performance becomes available and upon final reconciliation and settlement following the guarantee period. Amounts accrued and paid for these performance guarantees during the reporting periods were not material.
Expenses associated with administrative programs and services are recognized as incurred in Selling, general and administrative expenses.
The Company also earns revenue, as part of its integrated pharmacy benefits performance obligation, by offering fee-for-service clinical solutions to our clients, such as drug utilization management and medication adherence counseling. These clinical programs help clients to drive better health outcomes at a lower cost by identifying and addressing potentially unsafe or wasteful prescribing, dispensing and utilization of prescription drugs and communicating with, or supporting communications with physicians, pharmacies and patients. Fees are billed, due and recognized at contracted rates either on a periodic basis or as services are provided. This recognition pattern aligns with the benefits from services provided. These revenues are reported in Fees and other revenues in the Consolidated Statements of Income. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded as incurred in Selling, general and administrative expenses.
The Company earns fees from our Wholesale Marketplace Drug Formulary Management services. These services include either our drug formulary administrative service arrangements or our formulary processing arrangements. Drug formulary administrative services may include formulary consultation, administration of rebate contracts, rebate submission, collection from drug manufacturers and the distribution of rebates to clients. Services may also include facilitating audits of data submissions and reporting of rebates to clients. Clients agree to pay administrative fees that are billed, due and recognized at contracted rates as services are performed. These revenues are reported gross in Fees and other revenues and associated costs are reported in Pharmacy and other service costs in the Consolidated Statements of Income. For certain other clients in our formulary processing arrangements, the Company does not control the right to retain rebates before they are transferred to the client for services performed. Clients agree to allow the Company to retain a portion of each rebate collected in exchange for formulary processing services provided. These drug formulary service and administrative fee revenues are reported net in Fees and other revenues in the Consolidated Statements of Income. Revenue is recognized as rebates are processed.
The Company also earns fees by providing health benefit management solutions that drive cost reductions and improve quality outcomes. Clients are primarily sponsors of health benefit plans and fees may be stated as a per-member-per-month fee or as a per-claim fee. The Company considers the services to be a single performance obligation to stand ready to provide utilization management services over the contract period (generally three years). In certain arrangements, the Company assumes the financial obligation for third-party provider costs for medical services provided to the health plan's customers. Fees are recorded gross in Fees and other revenues in the Consolidated Statements of Income because the Company is acting as a principal in arranging for and controlling the services provided by third-party network providers. Contractual fees vary based on enrollment and provider costs and are billed, due and recognized monthly. Direct costs associated with these programs are recognized in Pharmacy and other service costs, and other related expenses are recorded in Selling, general and administrative expenses as incurred.
Certain health benefit management contracts require the Company to share the results of medical cost experience that differ from specified targets. This variable consideration is estimated at contract inception and adjusted through the contract period. The estimated profits and costs are recognized net in Fees and other revenues.
The Company also earns other service fees related to administrating services to specialty pharmacy manufacturers that are recorded in Fees and other revenues in the Consolidated Statements of Income. These revenues are billed, due and recognized at contracted rates as services are provided.
Accounts Receivable
Accounting policy. We bill pharmaceutical manufacturers based on management's interpretation of contractual terms and estimate a contractual allowance based on the best information available at the time a claim is processed. Contractual allowances for certain rebates receivable from pharmaceutical manufacturers are determined by reviewing payment experience and specific known items that could be adjusted under contract terms. The Company's estimation process for contractual allowances for pharmaceutical manufacturer receivables generally results in an allowance for balances outstanding greater than 90 days.
Contractual allowances for certain receivables from third-party payors are based on their contractual terms and are estimates based on the Company's best information available at the time revenue is recognized.
Allowances, discounts and claims adjustments issued to customers in the form of client credits and other non-credit adjustments are based on the current status of each customer's receivable balance, current economic and market conditions and a variety of other factors, including the length of time the receivables are past due, the financial health of customers and our past experience.
The allowance for expected credit losses for current accounts receivable is based primarily on past collections experience relative to the length of time receivables are past due; however, when available evidence reasonably supports an assumption that counterparty credit risk over the expected payment period will differ from current and historical payment collections, a forecasting adjustment is reflected in the allowance for expected credit losses.
Receivables and any associated allowance are written off only when all collection attempts have failed and such amounts are determined unrecoverable. We regularly review the adequacy of these allowances based on a variety of factors, including age of the outstanding receivable and collection history. When circumstances related to specific collection patterns change, estimates of the recoverability of receivables are adjusted.

The Company's accounts receivable include amounts due from pharmaceutical manufacturers, clients, third-party payors and customers, and are presented net of allowances. These balances include:

Pharmaceutical manufacturers receivables - amounts due from pharmaceutical manufacturers.
Noninsurance customer receivables - amounts due from customers for noninsurance services, primarily pharmacy benefit management and ASO contracts.
Insurance customer receivables - amounts due from customers under insurance and managed care contracts, primarily premiums receivable and amounts due from CMS.
Other receivables - all other accounts receivable not included in the categories above.
Assets and Liabilities of Businesses Held for Sale Accounting policy. The Company classifies assets and liabilities as held for sale ("disposal group") when management commits to a plan to sell the disposal group, the sale is probable within one year and the disposal group is available for immediate sale in its present condition. The Company considers various factors, particularly whether actions required to complete the plan indicate it is unlikely that significant changes to the plan will be made or the plan will be withdrawn. Assets held for sale are measured at the lower of carrying value or fair value less costs to sell. Any loss resulting from the measurement is recognized in the period the held-for-sale criteria are met. Conversely, gains are not recognized until the date of the sale. When the disposal group is classified as held for sale, depreciation and amortization for most long-lived assets ceases and the Company tests the assets for impairment. Deferred policy acquisition costs continue to be amortized.
Earnings Per Share Accounting policy. The Company computes basic earnings per share using the weighted-average number of unrestricted common and deferred shares outstanding. Diluted earnings per share also includes the dilutive effect of outstanding employee stock options and restricted stock using the treasury stock method and the effect of strategic performance shares.
Contractholder Deposit Funds Accounting policy - Contractholder Deposit Funds. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products and investment earnings on their fund balances. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. In addition, this caption includes: 1) premium stabilization reserves under group health insurance contracts representing experience refunds left with the Company to pay future premiums; 2) deposit administration funds used to fund non-pension retiree insurance programs; 3) retained asset accounts and 4) annuities or supplementary contracts without significant life contingencies. Interest credited on these funds is accrued ratably over the contract period.
Future Policy Benefits Accounting policy - Future Policy Benefits. Future policy benefits represent the present value of estimated future obligations under long-term life and supplemental health insurance policies and annuity products currently in force. These obligations are estimated using actuarial methods and consist primarily of reserves for annuity contracts, life insurance benefits, GMDB contracts (GMDB
contracts are fully reinsured, see Note 10 for additional information) and certain life and accident insurance products of our sold international businesses.
Obligations for annuities represent specified periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Obligations for life insurance policies and GMDB contracts represent benefits expected to be paid to policyholders, net of future premiums expected to be received. Management estimates these obligations based on assumptions as to premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders, allowing for adverse deviation as appropriate. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables. Interest rate assumptions are based on management's judgment considering the Company's experience and future expectations and range from 2% to 9%. Obligations for the direct and assumed run-off settlement annuity business include adjustments for realized and unrealized investment returns consistent with GAAP when a premium deficiency exists. As of December 31, 2022, approximately 24% of the liability for future policy benefits was supported by assets held in trust for the benefit of the ceding company under reinsurance agreements.
Unearned Premium Accounting policy - Unearned Premium. The unrecognized portion of premiums received is recorded as unearned premiums included in Insurance and contractholder liabilities (current and non-current).
Unpaid Claims and Claims Expenses This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, including expected development on reported claims, those that have been reported but not yet paid (reported claims in process) and other medical care expenses and services payable that are primarily comprised of accruals for incentives and other amounts payable to health care professionals and facilities.
Accounting policy. The Company uses actuarial principles and assumptions that are consistently applied each reporting period and recognizes the actuarial best estimate of the ultimate liability along with a margin for adverse deviation. This approach is consistent with actuarial standards of practice that the liabilities be adequate under moderately adverse conditions.
The Company compares key assumptions used to establish the medical costs payable to actual experience for each reporting period. The unpaid claims liability is adjusted through current period shareholders' net income when actual experience differs from these assumptions. Additionally, the Company evaluates expected future developments and emerging trends that may impact key assumptions. The process used to determine this liability requires the Company to make critical accounting estimates that involve considerable judgment, reflecting the variability inherent in forecasting future claim payments. These estimates are highly sensitive to changes in the Company's key assumptions, specifically completion factors and medical cost trend.
The liability is primarily calculated using "completion factors" developed by comparing the claim incurral date to the date claims were paid. Completion factors are impacted by several key items including changes in: 1) electronic (auto-adjudication) versus manual claim processing; 2) frequency and timeliness of provider claims submissions; 3) number of customers and 4) the mix of products. The Company uses historical completion factors combined with an analysis of current trends and operational factors to develop current estimates of completion factors. The Company estimates the liability for claims incurred in each month by applying the current estimates of completion factors to the current paid claims data. This approach implicitly assumes that historical completion rates will be a useful indicator for the current period.
The Company relies more heavily on medical cost trend analysis that reflects expected claim payment patterns and other relevant operational considerations for more recent months. Medical cost trend is primarily impacted by medical service utilization and unit costs that are affected by changes in the level and mix of health benefits offered, including inpatient, outpatient and pharmacy, the impact of copays and deductibles, changes in provider practices and changes in consumer demographics and consumption behavior.
There is no single or common claim frequency metric used in the health care industry. The Company believes a relevant metric for its health insurance business is the number of customers for whom an insured medical claim was paid. Customers for whom no insured medical claim was paid are excluded from the calculation. Claims that did not result in a liability are not included in the frequency metric. The claim frequency for 2022 and 2021 was approximately 5 million.
Accounting policy. Liabilities for unpaid claims and claim expenses are established by book of business within Other Operations including the liabilities divested in the Chubb transaction and divested through the sale of our ownership interest in a joint venture in Türkiye ("divested International businesses"). Unpaid claims and claim expenses within Other Operations consist of (1) case or claims reserves for reported claims that are unpaid as of the balance sheet date; (2) incurred but not reported reserves for claims when the insured event has occurred but has not been reported to the Company and (3) loss adjustment expense reserves for the expected costs of settling these claims. The Company consistently estimates incurred but not yet reported losses using actuarial principles and assumptions based on historical and projected claim incidence patterns, claim size and the expected payment period. The Company recognizes the actuarial best estimate of the ultimate liability within a level of confidence, consistent with actuarial standards of practice that the liabilities be adequate under moderately adverse conditions. The Company immediately records an adjustment in Medical costs and other benefit expenses when estimates of these liabilities change.
See Note 4 for a discussion of the divestiture of the Group Disability and Life business on December 31, 2020. Prior to the sale, the liabilities for unpaid claims and claim expenses in the Group Disability and Life business reflected reserves for long-term and short-term disability, life insurance and accident products. The majority of the unpaid claim liability related to disability claims that was measured as the present value of estimated future benefit payments, including expected development, for each reported claim that was receiving benefit payments over the expected disability period or pending a decision on eligibility for benefits.
Reinsurance Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 for additional information on reinsuranceThe Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.Accounting policy. Reinsurance recoverables represent amounts due from reinsurers for both paid and unpaid claims of the Company's insurance businesses. The Company bears the risk of loss if its reinsurers and retrocessionaires do not meet or are unable to meet their reinsurance obligations to the Company. Most reinsurance recoverables are classified as non-current assets. The current portion of reinsurance recoverables is reported in Other current assets and consists primarily of recoverables on paid claims expected to be settled within one year. Reinsurance recoverables are presented net of allowances, consisting primarily of an allowance for expected credit losses which is recognized on reinsurance recoverable balances each period and adjusted through Medical costs and other benefit expenses. Estimates of the allowance for expected credit losses are based on internal and external data used to develop expected loss rates over the anticipated duration of the recoverable asset that vary by external credit rating and collateral level. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables.Collateral levels are defined internally based on the fair value of the collateral relative to the carrying amount of the reinsurance recoverable, the frequency at which collateral is required to be replenished and the potential for volatility in the collateral's fair value.GMDB is accounted for as assumed and ceded reinsurance and GMIB assets and liabilities are reported as derivatives at fair value as discussed below. GMIB assets are reported in Other current assets and Other assets and GMIB liabilities are reported in Accrued expenses and other liabilities and Other non-current liabilities. Accounting policy. The Company estimates the gross liability and reinsurance recoverable with an internal model based on the Company's experience and future expectations over an extended period, consistent with the long-term nature of this product. As a result of the reinsurance transaction, reserve increases have a corresponding increase in the recorded reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit (including the GMIB asset presented below).
Accounting policy. The Company reports GMIB liabilities and assets as derivatives at fair value because cash flows of these liabilities and assets are affected by equity markets and interest rates, but are without significant life insurance risk and are settled in lump sum payments. The Company receives and pays fees periodically based on either contractholders' account values or deposits increased at a contractual rate. The Company will also pay and receive cash depending on changes in account values and interest rates when contractholders first elect to receive minimum income payments.
Assumptions used in fair value measurement. GMIB assets and liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates). The Company classifies GMIB assets and liabilities in Level 3 of the fair value hierarchy described in Note 12 because assumptions related to future annuitant behavior are largely unobservable.
The only assumption expected to impact future shareholders' net income is non-performance risk. The non-performance risk adjustment reflects a market participant's view of nonpayment risk by adding an additional spread to the discount rate in the calculation of both (a) the GMIB liabilities to be paid by the Company and (b) the GMIB assets to be paid by the reinsurers, after considering collateral.
Investments
The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 for information about the valuation of the Company's investment portfolio.

Debt securities, commercial mortgage loans, derivative financial instruments and short-term investments with contractual maturities during the next twelve months are classified on the balance sheet as current investments, unless they are held as statutory deposits or restricted for other purposes and then they are classified in Long-term investments. Equity securities may include funds that are used in our cash management strategy and are classified as current investments. All other investments are classified as Long-term investments.
Accounting policy. Debt securities (including bonds, mortgage and other asset-backed securities and preferred stocks redeemable by the investor) are classified as available for sale and are carried at fair value with changes in fair value recorded either in Accumulated other comprehensive loss within Shareholders' equity or in credit loss expense based on fluctuations in the allowance for credit losses, as further discussed below. Net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business is reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive loss. When the Company intends to sell or determines that it is more likely than not to be required to sell an impaired debt security, the excess of amortized cost over fair value is directly written down with a charge to Net realized investment (losses) gains. Certain asset-backed securities are considered variable interest entities. See Note 13 for additional information.
The Company reviews declines in fair value from a debt security's amortized cost basis to determine whether a credit loss exists, and when appropriate, recognizes a credit loss allowance with a corresponding charge to credit loss expense, presented in Net realized investment (losses) gains in the Company's Consolidated Statements of Income. The allowance for credit loss represents the excess of amortized cost over the greater of its fair value or the net present value of the debt security's projected future cash flows (based on qualitative and quantitative factors, including the probability of default and the estimated timing and amount of recovery). Each period, the allowance for credit loss is adjusted as needed through credit loss expense.
The Company does not measure an allowance for credit losses for accrued interest receivables. When interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured, accrued interest, reported in Other current assets, is written off through a charge to Net investment income and interest income is recognized on a cash basis.
Review of declines in fair value. Management reviews impaired debt securities to determine whether a credit loss allowance is needed based on criteria that include:
severity of decline;
financial health and specific prospects of the issuer; and
changes in the regulatory, economic or general market environment of the issuer's industry or geographic region.
Accounting policy. Equity securities with a readily determinable fair value consist primarily of public equity investments in the health care sector and mutual funds that invest in fixed income debt securities while those without a readily determinable fair value consist of private equity investments. Changes in the fair values of equity securities that have a readily determinable fair value are reported in Net realized investment (losses) gains. Equity securities without a readily determinable fair value are carried at cost minus impairment, if any, plus or minus changes resulting from observable price changes.
Accounting policy. Commercial mortgage loans are carried at unpaid principal balances, net of an allowance for expected credit losses, and classified as either current or long-term investments based on their contractual maturities. Changes in the allowance for expected credit losses are recognized as credit loss expense and presented in Net realized investment (losses) gains in the Company's Consolidated Statements of Income.
Each period, the Company establishes (or adjusts) its allowance for expected credit losses for commercial mortgage loans. The allowance for expected credit losses is based on a credit risk category that is assigned to each loan at origination using key credit quality indicators, including debt service coverage and loan-to-value ratios. Credit risk categories are updated as key credit quality indicators change. An expected loss rate, assigned based on the credit risk category, is applied to each loan's unpaid principal balance to develop the aggregate allowance for expected credit losses. Commercial mortgage loans are considered impaired and written off against the allowance when it is probable that the Company will not collect all amounts due per the terms of the promissory note. In the event of a foreclosure, the allowance for credit losses is based on the excess of the carrying value of the mortgage loan over the fair value of its underlying collateral.
Mortgage loans held by the Company are made exclusively to commercial borrowers and are diversified by property type, location and borrower. Loans are generally issued at fixed rates of interest and are secured by high quality, primarily completed and substantially leased operating properties.
Credit quality. The Company regularly evaluates and monitors credit risk, beginning with the initial underwriting of a mortgage loan and continuing throughout the investment holding period. Mortgage origination professionals employ an internal credit quality rating system designed to evaluate the relative risk of the transaction at origination that is then updated each year as part of the annual portfolio loan review. The Company evaluates and monitors credit quality on a consistent and ongoing basis.
Quality ratings are based on our evaluation of a number of key inputs related to the loan, including real estate market-related factors such as rental rates and vacancies, and property-specific inputs such as growth rate assumptions and lease rollover statistics. However, the two most significant contributors to the credit quality rating are the debt service coverage and loan-to-value ratios. The debt service coverage ratio measures the amount of property cash flow available to meet annual interest and principal payments on debt, with a ratio below 1.0 indicating that there is not enough cash flow to cover the required loan payments. The loan-to-value ratio, commonly expressed as a percentage, compares the amount of the loan to the fair value of the underlying property collateralizing the loan.
Accounting policy. Policy loans, primarily associated with our corporate-owned life insurance business, are carried at unpaid principal balances plus accumulated interest, the total of which approximates fair value. These loans are collateralized by life insurance policy cash values and therefore have minimal exposure to credit loss. Interest rates are reset annually based on a rolling average of benchmark interest rates.
Accounting policy. Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans and health care-related investments. These investments are carried at cost plus the Company's ownership percentage of reporting income or loss, based on the financial statements of the underlying investments that are generally reported at fair value. Income or loss from these investments is reported on a one quarter lag due to the timing of when financial information is received from the general partner or manager of the investments.
Other long-term investments also include investment real estate carried at depreciated cost less any impairment write-downs to fair value when cash flows indicate that the carrying value may not be recoverable. Depreciation is generally recorded using the straight-line method based on the estimated useful life of each asset. Investment real estate as of December 31, 2022 and 2021 is expected to be held longer than one year and may include real estate acquired through the foreclosure of commercial mortgage loans.
Additionally, foreign currency swaps carried at fair value as well as statutory and other restricted deposits are reported in the table below as "Other." See discussion below for information on the Company's accounting policies for derivative financial instruments.
Other long-term investments and related commitments are diversified by issuer, property type and geographic regions. These investments are primarily unconsolidated variable interest entities (see Note 13 for additional information).Our limited partnership investments are reduced as the Company receives cash distributions for returns on its investment that were previously recognized in Net investment income. Accounting policy. Security investments with maturities of greater than three months to one year from time of purchase are classified as short-term, available for sale and carried at fair value that approximates cost. Cash equivalents consist of short-term investments with maturities of three months or less from the time of purchase and are carried at cost that approximates fair value.Accounting policy. When interest and principal payments on investments are current, the Company recognizes interest income when it is earned. The Company recognizes interest income on a cash basis when interest payments are delinquent based on contractual terms or when certain terms (interest rate or maturity date) of the investment have been restructured. For unconsolidated entities that are included in other long-term investments investment income is generally recognized according to the Company's share of the reported income or loss on the underlying investments. Investment income attributed to the Company's separate accounts is excluded from our earnings because associated gains and losses generally accrue directly to separate account policyholders.Accounting policy. Realized investment gains and losses are based on specifically identified assets and result from sales, investment asset write-downs, change in the fair value of certain derivatives and equity securities and changes in allowances for credit losses on debt securities and commercial mortgage loan investments.
Derivative Financial Instruments The Company uses derivative financial instruments to manage the characteristics of investment assets (such as duration, yield, currency and liquidity) to meet the varying demands of the related insurance and contractholder liabilities. The Company also uses derivative financial instruments to hedge the risk of changes in the net assets of certain of its foreign subsidiaries due to changes in foreign currency exchange rates and to hedge the interest rate risk of certain long-term debt. The Company has written and purchased GMIB reinsurance contracts in its run-off reinsurance business that are accounted for as freestanding derivatives as discussed in Note 10. Derivatives in the Company's separate accounts are excluded from the following discussion because associated gains and losses generally accrue directly to separate account policyholders.Accounting policy. Derivatives are recorded in our Consolidated Balance Sheets at fair value and are classified as current or non-current according to their contractual maturities. Further information on our policies for determining fair value are discussed in Note 12. The Company applies hedge accounting when derivatives are designated, qualified and highly effective as hedges. Under hedge accounting, the changes in fair value of the derivative and the hedged risk are generally recognized together and offset each other
when reported in Shareholders' net income Various qualitative or quantitative methods appropriate for each hedge are used to formally assess and document hedge effectiveness at inception and each period throughout the life of a hedge.
The Company's derivative financial instruments are presented as follows: 
Fair value hedges of the foreign exchange-related changes in fair values of certain foreign-denominated bonds: Swap fair values are reported in Long-term investments or Other non-current liabilities. Offsetting changes in fair values attributable to the foreign exchange risk of the swap contracts and the hedged bonds are reported in Net realized investment (losses) gains. The portion of the swap contracts' changes in fair value excluded from the assessment of hedge effectiveness is recorded in Other comprehensive (loss) income and recognized in Net investment income as swap coupon payments are accrued, offsetting the foreign-denominated coupons received on the designated bonds. Net cash flows are reported in Operating activities, while exchanges of notional principal amounts are reported in Investing activities.
Fair value hedges of the interest rate exposure on the Company's long-term debt: Using fair value hedge accounting, the fair values of the swap contracts are reported in other assets or other liabilities. The critical terms of these swaps match those of the long-term debt being hedged. As a result, the carrying value of the hedged debt is adjusted to reflect changes in its fair value driven by the Secured Overnight Financing Rate ("SOFR"). The effects of those adjustments on interest expense are offset by the effects of corresponding changes in the swaps' fair value. The net impact from the hedge reported in Interest expense and other reflects interest expense on the hedged debt at the variable interest rate. Cash flows relating to these contracts are reported in Operating activities.
Net investment hedges of certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. dollar: The fair values of the foreign currency swap and forward contracts are reported in other assets or other liabilities. The changes in fair values of these instruments are reported in Other comprehensive (loss) income, specifically in translation of foreign currencies. The portion of the change in fair values relating to foreign exchange spot rates will be recognized in earnings upon deconsolidation of the hedged foreign subsidiaries. The remaining changes in fair value of these instruments are excluded from our effectiveness assessment and recognized in Interest expense and other over the term of the instrument. Cash flows relating to these contracts are reported in Investing activities.
Economic hedges for derivatives not designated as accounting hedges: Fair values of forward contracts are reported in Investments (current) or Accrued expenses and other liabilities. The changes in fair values are reported in Net realized investment (losses) gains. Cash flows relating to these contracts are reported in Investing activities.
Fair value hedge: To hedge the foreign exchange-related changes in fair values of certain foreign-denominated bonds. The notional value of these derivatives matches the amortized cost of the hedged bonds. A majority of these instruments are denominated in Euros, with the remaining instruments denominated in British Pounds Sterling and Australian Dollars.Fair value hedge: To convert a portion of the interest rate exposure on the Company's long-term debt from fixed to variable rates. This more closely aligns the Company's interest expense with the interest income received on its cash equivalent and short-term investment balances. The variable rates are benchmarked to SOFR.Net investment hedge: To reduce the risk of changes in net assets due to changes in foreign currency spot exchange rates for certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Foreign currency swap contracts are denominated in Euros.
Fair Value Measurements
The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.
Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.
The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's
fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).
The Company estimates fair values using prices from third parties or internal pricing methods. Fair value estimates received from third-party pricing services are based on reported trade activity and quoted market prices when available and other market information that a market participant would use to estimate fair value. The internal pricing methods are performed by the Company's investment professionals and generally involve using discounted cash flow analyses, incorporating current market inputs for similar financial instruments with comparable terms and credit quality as well as other qualitative factors. In instances where there is little or no market activity for the same or similar instruments, fair value is estimated using methods, models and assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. These valuation techniques involve some level of estimation and judgment that becomes significant with increasingly complex instruments or pricing models.
The Company is responsible for determining fair value and for assigning the appropriate level within the fair value hierarchy based on the significance of unobservable inputs. The Company reviews methodologies, processes and controls of third-party pricing services and compares prices on a test basis to those obtained from other external pricing sources or internal estimates. The Company performs ongoing analyses of both prices received from third-party pricing services and those developed internally to determine that they represent appropriate estimates of fair value. The controls executed by the Company include evaluating changes in prices and monitoring for potentially stale valuations. The Company also performs sample testing of sales values to confirm the accuracy of prior fair value estimates. The minimal exceptions identified during these processes indicate that adjustments to prices are infrequent and do not significantly impact valuations. An annual due-diligence review of the most significant pricing service is conducted to review their processes, methodologies and controls. This review includes a walk-through of inputs for a sample of securities held across various asset types to validate the documented pricing process.
Level 1 Financial Assets
Inputs for instruments classified in Level 1 include unadjusted quoted prices for identical assets in active markets accessible at the measurement date. Active markets provide pricing data for trades occurring at least weekly and include exchanges and dealer markets.
Assets in Level 1 include actively-traded U.S. government bonds and exchange-listed equity securities. A relatively small portion of the Company's investment assets are classified in this category given the narrow definition of Level 1 and the Company's investment asset strategy to maximize investment returns.
Level 2 Financial Assets and Financial Liabilities
Inputs for instruments classified in Level 2 include quoted prices for similar assets or liabilities in active markets, quoted prices from those willing to trade in markets that are not active or other inputs that are market observable or can be corroborated by market data for the term of the instrument. Such other inputs include market interest rates and volatilities, spreads and yield curves. An instrument is classified in Level 2 if the Company determines that unobservable inputs are insignificant.
Debt and equity securities. Approximately 94% of the Company's investments in debt and equity securities are classified in Level 2 including most public and private corporate debt and equity securities, federal agency and municipal bonds, non-government mortgage-backed securities and preferred stocks. Third-party pricing services and internal methods often use recent trades of securities with similar features and characteristics because many debt securities do not trade daily. Pricing models are used to determine these prices when recent trades are not available. These models calculate fair values by discounting future cash flows at estimated market interest rates. Such market rates are derived by calculating the appropriate spreads over comparable U.S. Treasury securities based on the credit quality, industry and structure of the asset. Typical inputs and assumptions to pricing models include, but are not limited to, a combination of benchmark yields, reported trades, issuer spreads, liquidity, benchmark securities, bids, offers, reference data and industry and economic events. For mortgage-backed securities, inputs and assumptions may also include characteristics of the issuer, collateral attributes, prepayment speeds and credit rating. Nearly all of these instruments are valued using recent trades or pricing models.
Short-term investments are carried at fair value that approximates cost. The Company compares market prices for these securities to recorded amounts on a regular basis to validate that current carrying amounts approximate exit prices. The short-term nature of the investments and corroboration of the reported amounts over the holding period support their classification in Level 2.
Derivative assets and liabilities classified in Level 2 represent over-the-counter instruments such as foreign currency forward and swap contracts. Fair values for these instruments are determined using market observable inputs including forward currency and interest rate curves and widely published market observable indices. Credit risk related to the counterparty and the Company is considered when estimating the fair values of these derivatives. However, the Company is largely protected by collateral arrangements with counterparties and determined that no adjustments for credit risk were required as of December 31, 2022 or December 31, 2021. The nature and use of these derivative financial instruments are described in Note 11.
Level 3 Financial Assets and Financial Liabilities
Certain inputs for instruments classified in Level 3 are unobservable (supported by little or no market activity) and significant to their resulting fair value measurement. Unobservable inputs reflect the Company's best estimate of what hypothetical market participants would use to determine a transaction price for the asset or liability at the reporting date.
The Company classifies certain newly-issued, privately-placed, complex or illiquid securities in Level 3. Approximately 5% of debt and equity securities are priced using significant unobservable inputs and classified in this category.
Fair values of mortgage and other asset-backed securities, as well as corporate and government debt securities, are primarily determined using pricing models that incorporate the specific characteristics of each asset and related assumptions including the investment type and structure, credit quality, industry and maturity date in comparison to current market indices, spreads and liquidity of assets with similar characteristics. Inputs and assumptions for pricing may also include characteristics of the issuer, collateral attributes and prepayment speeds for mortgage and other asset-backed securities. Recent trades in the subject security or similar securities are assessed when available, and the Company may also review published research in its evaluation, as well as the issuer's financial statements.
Quantitative Information about Unobservable InputsThe significant unobservable input used to value our corporate and government debt securities and mortgage and other asset-backed securities is an adjustment for liquidity. This adjustment is needed to reflect current market conditions and issuer circumstances when there is limited trading activity for the security.
Total gains and losses included in Shareholders' net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment (losses) gains and Net investment income.
Gains and losses included in Other comprehensive (loss) income, net of tax in the tables above are reflected in Net unrealized depreciation on securities and derivatives in the Consolidated Statements of Comprehensive Income.
Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market
activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreadsAssets and Liabilities Measured at Fair Value under Certain ConditionsSome financial assets and liabilities are not carried at fair value, such as commercial mortgage loans that are carried at unpaid principal, investment real estate that is carried at depreciated cost and equity securities with no readily determinable fair value when there are no observable market transactions. However, these financial assets and liabilities may be measured using fair value under certain conditions, such as when investments become impaired and are written down to their fair value, or when there are observable price changes from orderly market transactions of equity securities that otherwise had no readily determinable fair value.
Separate Accounts Accounting policy. Separate account assets and liabilities are contractholder funds maintained in accounts with specific investment objectives. The assets of these accounts are legally segregated and are not subject to claims that arise out of any of the Company's other businesses. These separate account assets are carried at fair value with equal amounts recorded for related separate account liabilities. The investment income and fair value gains and losses of separate account assets generally accrue directly to the contractholders and, together with their deposits and withdrawals, are excluded from the Company's Consolidated Statements of Income and Cash Flows. Fees and charges earned for mortality risks, asset management or administrative services are reported in either Premiums or Fees and other revenues. Investments that are measured using the practical expedient of net asset value ("NAV") are excluded from the fair value hierarchy.
Separate account assets classified as Level 1 primarily include exchange-listed equity securities. Level 2 assets primarily include:
corporate and structured bonds valued using recent trades of similar securities or pricing models that discount future cash flows at estimated market interest rates as described above; and
actively-traded institutional and retail mutual fund investments.
Separate account assets classified in Level 3 primarily support the Company's pension plans and include certain newly-issued, privately-placed, complex or illiquid securities that are priced using methods discussed above, as well as commercial mortgage loans. Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments
Variable Interest Entities
When the Company becomes involved with a variable interest entity and when there is a change in the Company's involvement with an entity, the Company must determine if it is the primary beneficiary and must consolidate the entity. The Company is considered the primary beneficiary if it has the power to direct the entity's most significant economic activities and has the right to receive benefits or obligation to absorb losses that could be significant to the entity. The Company evaluates the following criteria:
the structure and purpose of the entity;
the risks and rewards created by and shared through the entity; and
the Company's ability to direct its activities, receive its benefits and absorb its losses relative to the other parties involved with the entity including its sponsors, equity holders, guarantors, creditors and servicers.
Securities limited partnerships and real estate limited partnerships. The Company owns interests in securities limited partnerships and real estate limited partnerships that are defined as unconsolidated variable interest entities. These partnerships invest in the equity or mezzanine debt of privately-held companies and real estate properties. General partners unaffiliated with the Company control decisions that most significantly impact the partnership's operations and the limited partners do not have substantive kick-out or participating rights. The Company has invested in approximately 175 limited partnerships that have a carrying value of $2.7 billion as of December 31, 2022 reported in other long-term investments. We have commitments to contribute an additional $2.1 billion to these entities. The Company's maximum exposure to loss from these investments is $4.8 billion, calculated as the sum of our carrying value and the additional funding commitments. Our noncontrolling interest in each of these limited partnerships is generally less than 10% of the partnership ownership interests. See Note 11 for further information on the Company's accounting policy for other long-term investments.

The Company has guaranteed debt payments to mortgage lenders for certain real estate limited partnerships should potential environmental obligations arise. No liability has been incurred related to these guarantees, and the Company's maximum exposure to these guarantees was approximately $340 million as of December 31, 2022.

Other variable interest entities. The Company is involved in other types of variable interest entities, including certain asset-backed and corporate securities, real estate joint ventures that develop properties for residential and commercial use, independent physician associations ("IPAs") that provide care management services and international health care joint ventures. The Company's maximum exposure to loss is $0.6 billion from certain asset-backed and corporate securities and $0.6 billion from real estate joint ventures, which represents the sum of our carrying value and the additional funding commitments for these entities. The carrying values and maximum exposures for the remaining unconsolidated variable interest entities were not material as of December 31, 2022.
The Company has not provided, and does not intend to provide, financial support to any of the variable interest entities in excess of its maximum exposure. We perform ongoing qualitative analyses of our involvement with these variable interest entities to determine if consolidation is required.
Equity Method Operating Joint Ventures We record in our Consolidated Statements of Income our proportionate share of net income or loss generated by equity method operating joint ventures within Fees and other revenues. In certain instances, income or loss is reported on a one month lag due to the timing of when financial information is received.
AOCI AOCI includes net unrealized (depreciation) appreciation on securities and derivatives (excluding appreciation on investments supporting future policy benefit liabilities of the run-off settlement annuity business) (see Note 11), foreign currency translation and the net postretirement benefits liability adjustment. AOCI also includes the Company's share from unconsolidated entities accounted for under the equity method. Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net income in the same period that the related pre-tax AOCI reclassifications are recognized.
Pension Plans Accounting policy. The Company measures the assets and liabilities of its domestic pension plans as of December 31. Benefit obligations are measured at the present value of estimated future payments based on actuarial assumptions. The Company uses the corridor method to account for changes in the benefit obligation when actual results differ from those assumed, or when assumptions change. These changes are called net unrecognized actuarial gains (losses). Under the corridor method, net unrecognized actuarial gains (losses) are initially recorded in Accumulated other comprehensive loss. When the unrecognized gain (loss) exceeds 10% of the benefit obligation, that excess is amortized to expense over the expected remaining lives of plan participants. The net plan expense is reported in Interest expense and other in the Consolidated Statements of Income.For balance sheet purposes, we measure plan assets at fair value. When the actual return differs from the expected return, those differences are reflected in the net unrealized actuarial gain (loss) discussed above. However, to measure pension benefit costs, we use a market-related asset valuation that differs from the actual fair value for domestic pension plan assets invested in non-fixed income investments. The market-related value recognizes the difference between actual and expected long-term returns in the portfolio over five years, a method that reduces the short-term impact of market fluctuations on pension costs.
The Company develops discount rates by applying actual annualized yields for high-quality bonds by duration to the expected pension plan liability cash flows. The bond yields represent a diverse mix of actively traded high quality fixed-income securities that have an above average return at each duration as management believes this approach is representative of the yield achieved through plan asset investment strategy.
The expected long-term return on plan assets was developed considering historical long-term actual returns, expected long-term market conditions, plan asset mix and management's plan asset investment strategy.
See Note 12 for further details regarding how fair value is determined, including the level within the fair value hierarchy and the procedures we use to validate fair value measurements. The Company classifies substantially all debt securities in Level 2 for pension plan assets. These assets are valued using recent trades of similar securities or are fund investments priced using their daily net asset value that is the exit price. Approximately one-third of equity securities are classified in Level 1 because they are priced according to unadjusted quotes from active markets, while another one-third of this balance is classified in Level 2 and priced using the daily net asset value. The remaining balance of equity securities is classified in Level 3.
Securities partnerships, real estate and hedge funds are valued using net asset value as a practical expedient and are excluded from the fair value hierarchy. See Note 12 for additional disclosures related to these assets invested in the separate accounts of the Company's subsidiary. Certain securities as described in Note 12, as well as commercial mortgage loans and guaranteed deposit account contracts, are classified in Level 3 because unobservable inputs used in their valuation are significant.
Employee Incentive Plans The Company records compensation expense for stock and option awards over their vesting periods primarily based on the estimated fair value at the grant date. Fair value is determined differently for each type of award as discussed below.Accounting policy. The Company awards options to purchase The Cigna Group common stock at the market price of the stock on the grant date. Options vest over periods ranging from one year to three years and expire no later than 10 years from grant date. Fair value is estimated using the Black-Scholes option-pricing model by applying the assumptions presented below. That fair value is reduced by options expected to be forfeited during the vesting period. The Company estimates forfeitures at the grant date based on our experience and adjusts the expense to reflect actual forfeitures over the vesting period. The fair value of options, net of forfeitures, is recognized in Selling, general and administrative expenses on a straight-line basis over the vesting period.Accounting policy. Fair value of restricted stock awards is equal to the market price of The Cigna Group's common stock on the date of grant. This fair value is reduced by awards that are expected to forfeit. At the grant date, the Company estimates forfeitures based on experience and adjusts the expense to reflect actual forfeitures over the vesting period. This fair value, net of forfeitures, is recognized in Selling, general and administrative expenses over the vesting period on a straight-line basis.Accounting policy. Compensation expense for SPSs is recorded over the performance period. Fair value is determined at the grant date for "market condition" SPSs using a Monte Carlo simulation model and not subsequently adjusted regardless of the final outcome. Expense is initially accrued for "performance condition" SPSs based on the most likely outcome, but evaluated for adjustment each period for updates in the expected outcome. Expense is adjusted to the actual outcome (number of shares awarded times the share price at the grant date) at the end of the performance period.
Goodwill
Accounting policy. Goodwill represents the excess of the cost of businesses acquired over the fair value of their net assets. The resulting goodwill is assigned to those reporting units expected to realize cash flows from the acquisition, based on those reporting units' relative fair values. The Company's reporting units are aligned with its operating segments as described in Note 1.
The Company conducts its annual quantitative evaluation for goodwill impairment during the third quarter at the reporting unit level and writes it down through shareholders' net income if impaired. On a quarterly basis, the Company performs a qualitative impairment assessment to determine if events or changes in circumstances indicate that it is more likely than not that the carrying value of a reporting unit exceeds its estimated fair value. Fair value of a reporting unit is generally estimated based on discounted cash flow analysis and market approach models using assumptions that the Company believes a hypothetical market participant would use to determine a current transaction price. The significant assumptions and estimates used in determining fair value primarily include the discount rate and future cash flows. A discount rate is selected to correspond with each reporting unit's weighted average cost of capital, consistent with that used for investment decisions considering the specific and detailed operating plans and strategies within each reporting unit. Projections of future cash flows differ by reporting unit and are consistent with our ongoing strategic projections. Future cash flows for Evernorth Health Services are primarily driven by the forecasted gross margins of the business, as well as operating expenses and long-term growth rates. Future cash flows for our other reporting units are primarily driven by forecasted revenues, benefit expenses, operating expenses and long-term growth rates.
Other Intangible Assets
Accounting policy. The Company's Other intangible assets primarily include purchased customer and producer relationships, provider networks and trademarks. The fair value of purchased customer relationships and the amortization method were determined as of the dates of purchase using an income approach that relies on projected future net cash flows including key assumptions for customer attrition and discount rates. The Company's definite-lived intangible assets are amortized on an accelerated or straight-line basis, reflecting their pattern of economic benefits, over periods from three to 30 years. Management revises amortization periods if it believes there has been a change in the length of time that an intangible asset will continue to have value. Costs incurred to renew or extend the terms of these intangible assets are generally expensed as incurred.
The Company's amortized intangible assets are tested for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable. If the total of the expected future undiscounted cash flows generated by the underlying asset group is less than the carrying amount of the asset group, the Company recognizes an impairment charge equal to the difference between the carrying value of the asset group and its estimated fair value. The Company's indefinite-lived intangible assets are reviewed for impairment at least annually by comparing their fair value with their carrying value. If the carrying value exceeds fair value, that excess is recognized as an impairment loss.
Property and Equipment Accounting policy. Property and equipment is carried at cost less accumulated depreciation. Cost includes interest, real estate taxes and other costs incurred during construction when applicable. Internal-use software that is acquired, developed or modified solely to
meet the Company's internal needs, with no plan to market externally, is also included in this category. Costs directly related to acquiring, developing or modifying internal-use software are capitalized.
The Company calculates depreciation and amortization principally using the straight-line method generally based on the estimated useful life of each asset as follows: buildings and improvements, 10 to 40 years; purchased software, three to five years; internally developed software, three to seven years and furniture and equipment (including computer equipment), three to 10 years. Improvements to leased facilities are depreciated over the lesser of the remaining lease term or the estimated life of the improvement. The Company considers events and circumstances that would indicate the carrying value of property, equipment or capitalized software might not be recoverable. An impairment charge is recorded if the Company determines the carrying value of any of these assets is not recoverable. The Company also reviews and shortens the estimated useful lives of these assets, if necessary.
Leases The Company's leases are primarily for office space and certain computer and other equipment and have terms of up to 35 years.Accounting policy. The Company determines if an arrangement is a lease and its lease classification (operating or finance) at inception. Both operating and finance leases result in (1) a right-of-use ("ROU") asset that represents our right to use the underlying asset for the lease term and (2) a lease liability that represents our obligation to make lease payments arising from the lease.
These lease assets and liabilities are recognized at the lease commencement date based on the present value of the lease payments over the lease term. Most of the Company's leases do not provide an implicit rate, so the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. The ROU asset also includes any lease pre-payments made and excludes lease incentives for operating leases. The Company's expected life of a lease may consider options to extend or terminate a lease when it is reasonably certain that the Company will exercise that option.
The Company has lease agreements with lease and non-lease components that are accounted for as a single lease component. Operating lease ROU assets are amortized on a straight-line basis over the lease term, which is representative of the pattern in which benefit is expected to be derived from the right to use the underlying asset. Variable lease payments are expensed as incurred and represent amounts that are neither fixed in nature, such as maintenance and other services provided by the lessor, nor tied to an index or rate.
Income Taxes
Accounting policy. Deferred income taxes are reflected in the Consolidated Balance Sheets for differences between the financial and income tax reporting bases of the Company's underlying assets and liabilities, and are established based upon enacted tax rates and laws. Deferred income tax assets are recognized when available evidence indicates that realization is more likely than not and a valuation allowance is established to the extent this standard is not met. The deferred income tax provision generally represents the net change in deferred income tax assets and liabilities during the reporting period excluding adjustments to Accumulated other comprehensive income (loss) or amounts recorded in connection with a business combination. The current income tax provision generally represents estimated amounts due on income tax returns for the year reported to various jurisdictions plus the effect of any uncertain tax positions. The Company recognizes a liability for uncertain tax positions if management believes the probability that the positions will be sustained is 50% or less. For uncertain positions that management believes are more likely than not to be sustained, the Company recognizes a liability based upon management's estimate of the most likely settlement outcome with the taxing authority. The liabilities for uncertain tax positions are classified as current when the position is expected to be settled within 12 months or the statute of limitation expires within 12 months.
Income taxes attributable to the Company's foreign operations are generally provided using the respective foreign jurisdictions' tax rate.
Management believes that future results will be sufficient to realize a majority of the Company's gross deferred tax assets. As of December 31, 2022, we had approximately $270 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are primarily recorded in Accumulated other comprehensive loss. We have determined that a valuation allowance against the DTAs is not currently required based on the Company's ability to carryback losses and other known investment strategies. We will monitor and evaluate the need for any valuation allowance in the future. Valuation allowances are established against deferred tax assets when it is determined that it is more likely than not that the asset will not be recognized. Valuation allowances have been established against certain federal, state and foreign tax attributes. There are multiple expiration dates associated with these tax attributes.The Company classifies net interest expense on uncertain tax positions as a component of income tax expense and in Other non-current liabilities in the Consolidated Balance Sheets.
Guarantees Financial Guarantees: Retiree and Life Insurance BenefitsThe Company guarantees that separate account assets will be sufficient to pay certain life insurance or retiree benefits. For the majority of these benefits, the sponsoring employers are primarily responsible for ensuring that assets are sufficient to pay these benefits and are required to maintain assets that exceed a certain percentage of benefit obligations. If employers fail to do so, the Company or an affiliate of the buyer of the retirement benefits business has the right to redirect the management of the related assets to provide for benefit payments.An additional liability is established if management believes that the Company will be required to make payments under the guarantees;Separate account assets supporting these guarantees are classified in Levels 1 and 2 of the GAAP fair value hierarchy.Certain Other GuaranteesThe Company had indemnification obligations as of December 31, 2022 in connection with acquisition and disposition transactions. These indemnification obligations are triggered by the breach of representations or covenants provided by the Company, such as representations for the presentation of financial statements, filing of tax returns, compliance with law or identification of outstanding litigation. These obligations are typically subject to various time limitations, defined by the contract or by operation of law, such as statutes of limitation. In some cases, the maximum potential amount due is subject to contractual limitations based on a percentage of the transaction purchase price, while in other cases limitations are not specified or applicable. The Company does not believe that it is possible to determine the maximum potential amount due under these obligations because not all amounts due under these indemnification obligations are subject to limitation.Guaranty Fund AssessmentsThe Company operates in a regulatory environment that may require its participation in assessments under state insurance guaranty association laws. The Company's exposure to assessments for certain obligations of insolvent insurance companies to policyholders and claimants is based on its share of business written in the relevant jurisdictions.
Segment Information Intersegment revenues primarily reflect pharmacy-related transactions between the Evernorth Health Services and Cigna Healthcare segments.The Company uses "pre-tax adjusted income (loss) from operations" and "adjusted revenues" as its principal financial measures of segment operating performance because management believes these metrics best reflect the underlying results of business operations and permit analysis of trends in underlying revenue, expenses and profitability. We define pre-tax adjusted income from operations as income before income taxes 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 the Cigna Healthcare segment using the equity method of accounting are also excluded. Special items are matters that management believes are not representative of the underlying results of operations due to their nature or size. Adjusted income (loss) from operations is measured on an after-tax basis for consolidated results and on a pre-tax basis for segment results. The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and The Cigna Group's share of certain realized investment results of its joint ventures reported in the Cigna 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.
v3.22.4
Accounts Receivable, Net (Tables)
12 Months Ended
Dec. 31, 2022
Receivables [Abstract]  
Accounts Receivable, Net
The following amounts were included within Accounts receivable, net:
(In millions)December 31, 2022December 31, 2021
Pharmaceutical manufacturers receivables$7,108 $5,463 
Noninsurance customer receivables6,899 6,274 
Insurance customer receivables2,963 2,932 
Other receivables248 456 
Total15,125 
Accounts receivable, net classified as Assets of businesses held for sale
(54)
Accounts receivable, net per Consolidated Balance Sheets$17,218 $15,071 
v3.22.4
Assets and Liabilities of Businesses Held for Sale (Tables)
12 Months Ended
Dec. 31, 2022
Discontinued Operations and Disposal Groups [Abstract]  
Assets and Liabilities of Business Held for Sale The assets and liabilities of businesses held for sale were as follows:
(In millions)December 31, 2021
Cash and cash equivalents$406 
Investments5,109 
Deferred policy acquisition costs2,755 
Separate account assets878 
Goodwill, other intangible assets and all other assets909 
Total assets of businesses held for sale10,057 
Insurance and contractholder liabilities4,644 
Accounts payable, accrued expenses and other liabilities452 
Deferred tax liabilities, net449 
Separate account liabilities878 
Total liabilities of businesses held for sale$6,423 
v3.22.4
Earnings Per Share (Tables)
12 Months Ended
Dec. 31, 2022
Earnings Per Share [Abstract]  
Computation of Basic and Diluted Earnings Per Share Basic and diluted earnings per share were computed as follows:
For the Years Ended December 31,
202220212020
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution
DilutedBasicEffect of
Dilution
DilutedBasicEffect of
Dilution
Diluted
Shareholders' net income$6,668 $6,668 $5,365 $5,365 $8,458 $8,458 
Shares:
Weighted average309,546 309,546 337,962 337,962 364,979 364,979 
Common stock equivalents3,519 3,519 3,004 3,004 3,410 3,410 
Total shares309,546 3,519 313,065 337,962 3,004 340,966 364,979 3,410 368,389 
Earnings per share$21.54 $(0.24)$21.30 $15.87 $(0.14)$15.73 $23.17 $(0.21)$22.96 
Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share
The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive:
For the Years Ended December 31,
(In millions)202220212020
Anti-dilutive options1.0 1.5 4.1 
v3.22.4
Debt (Tables)
12 Months Ended
Dec. 31, 2022
Debt Disclosure [Abstract]  
Outstanding Amounts of Debt and Finance Leases
The outstanding amounts of debt, net of issuance costs, discounts or premiums, and finance leases were as follows:
(In millions)December 31, 2022December 31, 2021
Short-term debt
Commercial paper$ $2,027 
$500 million, 3.05% Notes due November 2022
 495 
$17 million, 8.3% Notes due January 2023
17 — 
$63 million, 7.65% Notes due March 2023
63 — 
$700 million, Floating Rate Notes due July 2023
700 — 
$1,000 million, 3.0% Notes due July 2023
994 — 
$1,187 million, 3.75% Notes due July 2023
1,186 — 
Other, including finance leases33 23 
Total short-term debt$2,993 $2,545 
Long-term debt
$17 million, 8.3% Notes due January 2023
$ $17 
$63 million, 7.65% Notes due March 2023
 63 
$700 million, Floating Rate Notes due July 2023
 699 
$1,000 million, 3% Notes due July 2023
 985 
$1,187 million, 3.75% Notes due July 2023
 1,185 
$500 million, 0.613% Notes due March 2024
499 498 
$1,000 million, 3.5% Notes due June 2024
990 983 
$900 million, 3.25% Notes due April 2025 (1)
872 897 
$2,200 million, 4.125% Notes due November 2025
2,195 2,193 
$1,500 million, 4.5% Notes due February 2026
1,503 1,504 
$800 million, 1.25% Notes due March 2026
797 796 
$1,500 million, 3.4% Notes due March 2027
1,436 1,423 
$259 million, 7.875% Debentures due May 2027
259 259 
$600 million, 3.05% Notes due October 2027
597 596 
$3,800 million, 4.375% Notes due October 2028
3,785 3,782 
$1,500 million, 2.4% Notes due March 2030
1,492 1,490 
$1,500 million, 2.375% Notes due March 2031 (1)
1,380 1,500 
$45 million, 8.3% Step Down Notes due January 2033 (2)
45 45 
$190 million, 6.15% Notes due November 2036
190 190 
$2,200 million, 4.8% Notes due August 2038
2,192 2,192 
$750 million, 3.2% Notes due March 2040
743 743 
$121 million, 5.875% Notes due March 2041
119 119 
$448 million, 6.125% Notes due November 2041
488 490 
$317 million, 5.375% Notes due February 2042
315 315 
$1,500 million, 4.8% Notes due July 2046
1,466 1,465 
$1,000 million, 3.875% Notes due October 2047
989 988 
$3,000 million, 4.9% Notes due December 2048
2,968 2,967 
$1,250 million, 3.4% Notes due March 2050
1,236 1,236 
$1,500 million, 3.4% Notes due March 2051
1,478 1,477 
Other, including finance leases66 28 
Total long-term debt$28,100 $31,125 
(1) The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 11 for further information about the Company's interest rate risk management and these derivative instruments.
(2) Interest rate step down to 8.08% effective January 15, 2023.
Maturities of Outstanding Long-Term Debt Maturities of outstanding long-term debt as of December 31, 2022 are as follows:
(In millions)
Scheduled Maturities (1)
2023$2,967 
2024$1,500 
2025$3,100 
2026$2,300 
2027$2,359 
Maturities after 2027$19,122 
(1) Long-term debt maturity amounts include current maturities of long-term debt. Finance leases are excluded from this table. See Note 20 - Leases for finance lease maturity amounts.
v3.22.4
Common and Preferred Stock (Tables)
12 Months Ended
Dec. 31, 2022
Equity [Abstract]  
Share Activity The following table presents the share activity of The Cigna Group:
For the Years Ended December 31,
(Shares in thousands)202220212020
Common: Par value $0.01; 600,000 shares authorized
Outstanding- January 1,322,948 354,771 372,531 
Net issued for stock option exercises and other benefit plans3,173 3,375 4,142 
Repurchased common stock(27,445)(35,198)(21,902)
Outstanding- December 31,298,676 322,948 354,771 
Treasury stock99,143 71,246 35,505 
Issued- December 31,397,819 394,194 390,276 
Dividend Payments
The following table provides details of the Company's dividend payments:
Record DatePayment DateAmount per Share
Total Amount Paid (in millions)
2022
March 9, 2022March 24, 2022$1.12$357
June 8, 2022June 23, 2022$1.12$352
September 7, 2022September 22, 2022$1.12$341
December 6, 2022December 21, 2022$1.12$334
2021
March 10, 2021March 25, 2021$1.00$345
June 8, 2021June 23, 2021$1.00$342
September 8, 2021September 23, 2021$1.00$330
December 7, 2021December 22, 2021$1.00$324
2020
March 10, 2020April 9, 2020$0.04$15
v3.22.4
Insurance and Contractholder Liabilities (Tables)
12 Months Ended
Dec. 31, 2022
Insurance Loss Reserves [Abstract]  
Summary of Insurance and Contractholder Liabilities, Activity in the Unpaid Claims Liability and Liability Details for Unpaid Claims and Claim Expenses
The Company's insurance and contractholder liabilities were comprised of the following:
December 31, 2022December 31, 2021
(In millions)CurrentNon-currentTotalCurrentNon-currentTotal
Contractholder deposit funds$365 $6,515 $6,880 $352 $6,702 $7,054 
Future policy benefits229 4,708 4,937 312 9,194 9,506 
Unearned premiums576 22 598 558 418 976 
Unpaid claims and claim expenses
Cigna Healthcare
4,117 59 4,176 4,159 102 4,261 
Other Operations98 177 275 548 180 728 
Total5,929 16,596 22,525 
Insurance and contractholder liabilities classified as Liabilities of businesses held for sale (1)
(611)(4,033)(4,644)
Total insurance and contractholder liabilities per Consolidated Balance Sheets$5,385 $11,481 $16,866 $5,318 $12,563 $17,881 
(1) Amounts classified as Liabilities of businesses held for sale primarily include $3.8 billion of Future policy benefits, $0.4 billion of Unpaid claims and $0.4 billion of Unearned premiums as of December 31, 2021.
Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows:
For the Years Ended December 31,
(In millions)202220212020
Beginning balance$4,261 $3,695 $3,336 
Less: Reinsurance and other amounts recoverable261 237 318 
Beginning balance, net4,000 3,458 3,018 
Incurred costs related to:
Current year31,342 31,755 27,494 
Prior years(259)(219)(144)
Total incurred31,083 31,536 27,350 
Paid costs related to:
Current year27,583 27,929 24,187 
Prior years3,545 3,065 2,723 
Total paid31,128 30,994 26,910 
Ending balance, net3,955 4,000 3,458 
Add: Reinsurance and other amounts recoverable221 261 237 
Ending balance$4,176 $4,261 $3,695 
Liability balance details. The liability details for unpaid claims and claim expenses are presented in the following table.
(In millions)December 31, 2022December 31, 2021
Other Operations
Divested International businesses
$ $447 
Other Operations275 281 
Unpaid claims and claim expenses - Other Operations
$275 $728 
Activity in the unpaid claims and claim expenses for the divested International and Group Disability and Life business is presented in the following table. Liabilities associated with Other Operations are excluded because they pertain to obligations for long-duration insurance contracts or, if short-duration, the liabilities have been largely reinsured.
For the Years Ended December 31,
(In millions)
2022 (1)
2021
2020
Beginning balance$447 $452 $5,372 
Less: Reinsurance46 45 169 
Beginning balance, net401 407 5,203 
Incurred claims related to:
Current year507 982 4,205 
Prior years:
Interest accretion — 154 
All other incurred3 11 48 
Total incurred510 993 4,407 
Paid claims related to:
Current year322 738 2,392 
Prior years187 227 1,690 
Total paid509 965 4,082 
Foreign currency(28)(34)21 
Divestiture of businesses(2)
(374)— (5,142)
Ending balance, net 401 407 
Add: Reinsurance 46 45 
Ending balance
$ $447 $452 
(1) Beginning balance includes unpaid claims amounts classified as Liabilities of businesses held for sale.
(2) 2020 amounts include Group Disability and Life reserves sold or reinsured to New York Life Insurance Company as part of the sale of the Group Disability and Life business and immaterial retained balances which are now excluded from this table.
Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
For the Years Ended December 31,
20222021
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors$62 0.2 %$81 0.3 %
Medical cost trend197 0.6 138 0.5 
Total favorable variance$259 0.8 %$219 0.8 %
(1) Percentage of current year incurred costs as reported for the year ended December 31, 2021.
(2) Percentage of current year incurred costs as reported for the year ended December 31, 2020.
Summary of Incurred and Paid Claims Development, Claims Frequency Metrics and Incurred but Not Yet Reported Liabilities The following table depicts the incurred and paid claims development and unpaid claims liability as of December 31, 2022 (net of reinsurance) reported in the Cigna Healthcare segment. The information about incurred and paid claims development for the year ended December 31, 2021 is presented as supplementary information and is unaudited.
 Incurred Costs 
Incurral Year2021
(Unaudited)
2022Unpaid Claims & Claim Expenses
(In millions)  
2021$30,735 $30,493 180 
202230,309 3,622 
Cumulative incurred costs for the periods presented$60,802  
 Cumulative Costs Paid 
Incurral Year2021
(Unaudited)
2022 
(In millions)
2021$27,039 $30,313  
202226,687  
Cumulative paid costs for the periods presented$57,000  
Outstanding liabilities for the periods presented, net of reinsurance$3,802  
Other long-duration liabilities not included in development table above153  
Net unpaid claims and claims expenses - Cigna Healthcare
3,955  
Reinsurance and other amounts recoverable221  
Unpaid claims and claim expenses - Cigna Healthcare
$4,176  
v3.22.4
Reinsurance (Tables)
12 Months Ended
Dec. 31, 2022
Reinsurance Disclosures [Abstract]  
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level
The Company's reinsurance recoverables as of December 31, 2022 are presented in the following table by range of external credit rating and collateral level:
(In millions)
Fair value of collateral contractually required to meet or exceed carrying value of recoverable
Collateral provisions exist that may mitigate risk of credit loss (3)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (1)
$ $ $87 $87 
BBB- to BBB+ equivalent current credit ratings (1)
  58 58 
Not rated139 4 43 186 
Total recoverables related to ongoing operations (2)
139 4 188 331 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York 2,795  2,795 
Berkshire Hathaway Life Insurance Company of Nebraska248 432  680 
Empower Annuity Insurance Company  133 133 
Prudential Insurance Company of America375  — 375 
Life Insurance Company of North America— 387 — 387 
Other203 19 16 238 
Not rated 12 3 15 
Total recoverables related to acquisition, disposition or run-off activities826 3,645 152 4,623 
Total$965 $3,649 $340 $4,954 
Allowance for uncollectible reinsurance(37)
Total reinsurance recoverables (2)
$4,917 
(1) Certified by a Nationally Recognized Statistical Rating Organization ("NRSRO").
(2) Includes $174 million of current reinsurance recoverables that are reported in Other current assets.
(3) Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
Effects of Reinsurance The following table presents direct, assumed and ceded premiums for both short-duration and long-duration insurance contracts. It also presents reinsurance recoveries that have been netted against Medical costs and other benefit expenses in the Company's Consolidated Statements of Income.
For the Years Ended December 31,
(In millions)202220212020
Premiums
Short-duration contracts
Direct$36,746 $36,513 $38,425 
Assumed416 335 85 
Ceded(265)(148)(230)
Total short-duration contract premiums36,897 36,700 38,280 
Long-duration contracts
Direct3,219 4,753 4,517 
Assumed85 99 99 
Ceded(286)(398)(269)
Total long-duration contract premiums3,018 4,454 4,347 
Total premiums$39,915 $41,154 $42,627 
Total reinsurance recoveries$702 $552 $431 
Account Value, Net Amount at Risk and the Number of Contractholders for Guarantees Assumed in the Event of Death
The following table presents the account value, net amount at risk and the number of contractholders for guarantees assumed by the Company in the event of death. The net amount at risk is the amount that the Company would have to pay if all contractholders died as of the specified date. As of December 31, 2022, the account value decreased primarily due to unfavorable equity market performance, which resulted in an increase to the net amount at risk. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded.
(Dollars in millions, excludes impact of reinsurance ceded)December 31, 2022December 31, 2021
Account value$7,436 $9,795 
Net amount at risk$2,114 $1,392 
Average attained age of contractholders (weighted by exposure)7577
Number of contractholders (estimated)150,000 170,000 
Schedule of Derivative Assets at Fair Value GMIB liabilities totaled $404 million as of December 31, 2022 and $572 million as of December 31, 2021. The GMIB liabilities reflect the Company's credit risk, while the reinsurance recoverable reflects the credit risk of the reinsurers. There were three reinsurers covering 100% of the GMIB exposures as of December 31, 2022 and December 31, 2021 as follows:
(In millions)
Line of BusinessReinsurerDecember 31, 2022December 31, 2021
Collateral and Other Terms at December 31, 2022
GMIBBerkshire$203 $283 
100% were secured by assets in a trust.
Sun Life Assurance Company of Canada119 167 
Liberty Re (Bermuda) Ltd.108 151 
100% were secured by assets in a trust.
Total GMIB recoverables reported in Other current assets and Other assets
$430 $601 
All reinsurers are rated A- equivalent and higher by an NRSRO.
v3.22.4
Investments (Tables)
12 Months Ended
Dec. 31, 2022
Investments [Abstract]  
Investments by category and current or long-term classification
The following table summarizes the Company's investments by category and current or long-term classification:
December 31, 2022December 31, 2021
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$654 $9,218 $9,872 $796 $16,162 $16,958 
Equity securities45 577 622 — 603 603 
Commercial mortgage loans67 1,547 1,614 40 1,526 1,566 
Policy loans 1,218 1,218 — 1,338 1,338 
Other long-term investments 3,728 3,728 — 3,574 3,574 
Short-term investments139  139 428 — 428 
Total1,264 23,203 24,467 
Investments classified as Assets of businesses held for sale (1)
(344)(4,765)(5,109)
Investments per Consolidated Balance Sheets$905 $16,288 $17,193 $920 $18,438 $19,358 
(1) Investments related to the divested International businesses that were held for sale as of December 31, 2021. These investments were primarily comprised of debt securities and other long-term investments, and to a lesser extent, equity securities and short-term investments. See Note 4 for additional information.
Debt Securities by Contractual Maturity
The amortized cost and fair value by contractual maturity periods for debt securities were as follows:
December 31, 2022
(In millions)Amortized
Cost
Fair
Value
Due in one year or less$681 $674 
Due after one year through five years3,817 3,583 
Due after five years through ten years3,457 3,052 
Due after ten years2,497 2,215 
Mortgage and other asset-backed securities390 348 
Total$10,842 $9,872 
Gross Unrealized Appreciation (Depreciation) on Debt Securities Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below:
(In millions)Amortized
Cost
Allowance for Credit LossUnrealized
Appreciation
Unrealized
Depreciation
Fair
Value
December 31, 2022
Federal government and agency$292 $ $32 $(12)$312 
State and local government43   (2)41 
Foreign government375  11 (21)365 
Corporate9,742 (44)89 (981)8,806 
Mortgage and other asset-backed390  1 (43)348 
Total$10,842 $(44)$133 $(1,059)$9,872 
December 31, 2021
Federal government and agency$287 $— $101 $(1)$387 
State and local government154 — 17 — 171 
Foreign government2,468 — 194 (46)2,616 
Corporate12,361 (23)1,008 (80)13,266 
Mortgage and other asset-backed505 — 17 (4)518 
Total$15,775 $(23)$1,337 $(131)$16,958 
Investments supporting liabilities of the Company's run-off settlement annuity business (included in total above) (1)
$2,262 $(5)$720 $(10)$2,967 
(1) Net unrealized appreciation for these investments is excluded from Accumulated other comprehensive loss. As of December 31, 2022, net unrealized depreciation for these investments is included in Accumulated other comprehensive loss.
Summary of Debt Securities with a Decline in Fair Value
The table below summarizes debt securities with a decline in fair value from amortized cost for which an allowance for credit losses has not been recorded, by investment grade and the length of time these securities have been in an unrealized loss position. Unrealized depreciation on these debt securities is primarily due to declines in fair value resulting from increasing interest rates since these securities were purchased.
December 31, 2022December 31, 2021
(Dollars in millions)Fair
Value
Amortized
Cost
Unrealized
Depreciation
Number
of Issues
Fair
Value
Amortized
Cost
Unrealized
Depreciation
Number
of Issues
One year or less
Investment grade$5,533 $6,127 $(594)1,659$2,785 $2,861 $(76)909 
Below investment grade887 964 (77)1,287561 578 (17)781 
More than one year
Investment grade1,151 1,487 (336)462382 412 (30)143 
Below investment grade330 382 (52)369162 170 (8)53 
Total$7,901 $8,960 $(1,059)3,777 $3,890 $4,021 $(131)1,886 
Equity Security Investments The following table provides the values of the Company's equity security investments. The amount of impairments or value changes resulting from observable price changes on equity securities with no readily determinable fair value still held was not material to the financial statements as of December 31, 2022 or 2021.
December 31, 2022 December 31, 2021
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$673 $138 $257 $207 
Equity securities with no readily determinable fair value380 484 270 396 
Total$1,053 $622 $527 $603 
Summary of the Credit Risk Profile of the Commercial Mortgage Loan Portfolio
The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:
(Dollars in millions)December 31, 2022December 31, 2021
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$901 2.12$560 2.18
60% to 79%564 1.73883 1.89
80% to 100%149 1.17123 1.47
Total$1,614 1.8960 %$1,566 1.9661 %
Carrying Value Information for Other Long-Term Investments The following table provides unfunded commitment and carrying value information for these investments. The Company expects to disburse approximately 30% of the committed amounts in 2023. Our limited partnership investments are reduced as the Company receives cash distributions for returns on its investment that were previously recognized in Net investment income. The amount of these cash distributions was $487 million in 2022, $568 million in 2021 and $227 million in 2020.
Unfunded Commitments as of
Carrying Value as of December 31,
(In millions)20222021December 31, 2022
Real estate investments$1,319 $1,152 $668 
Securities partnerships2,166 2,272 1,704 
Other243 150  
Total$3,728 $3,574 $2,372 
Summary of Derivative Instruments Held The following table summarizes the types and notional quantity of derivative instruments held by the Company:
Notional Value as of
(In millions)December 31, 2022December 31, 2021
PurposeType of Instrument
Fair value hedge: To hedge the foreign exchange-related changes in fair values of certain foreign-denominated bonds. The notional value of these derivatives matches the amortized cost of the hedged bonds. A majority of these instruments are denominated in Euros, with the remaining instruments denominated in British Pounds Sterling and Australian Dollars.
Foreign currency swap contracts
$1,083 $1,081 
Fair value hedge: To convert a portion of the interest rate exposure on the Company's long-term debt from fixed to variable rates. This more closely aligns the Company's interest expense with the interest income received on its cash equivalent and short-term investment balances. The variable rates are benchmarked to SOFR.
Interest rate swap contracts$1,500 $750 
Net investment hedge: To reduce the risk of changes in net assets due to changes in foreign currency spot exchange rates for certain foreign subsidiaries that conduct their business principally in currencies other than the U.S. Dollar. The notional value of hedging instruments matches the hedged amount of subsidiary net assets. Foreign currency swap contracts are denominated in Euros.
Foreign currency swap contracts
$460 $526 
Components of Net Investment Income The components of Net investment income were as follows:
For the Years Ended December 31,
(In millions)202220212020
Debt Securities$572 $689 $962 
Equity securities14 12 11 
Commercial mortgage loans59 60 80 
Policy loans59 63 64 
Other long-term investments390 758 127 
Short-term investments and cash115 26 52 
Total investment income1,209 1,608 1,296 
Less investment expenses54 59 52 
Net investment income$1,155 $1,549 $1,244 
Realized Gains and Losses on Investments
The following realized gains and losses on investments exclude amounts required to adjust future policy benefits for the run-off settlement annuity business (consistent with accounting for a premium deficiency), as well as realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders:
For the Years Ended December 31,
(In millions)202220212020
Net realized investment (losses) gains, excluding credit loss expense and asset write-downs
$(459)$194 $186 
Credit loss (expense) recoveries
(36)(27)
Other investment asset write-downs — (10)
Net realized investment (losses) gains, before income taxes
$(495)$196 $149 
v3.22.4
Fair Value Measurements (Tables)
12 Months Ended
Dec. 31, 2022
Fair Value Disclosures [Abstract]  
Financial Assets and Financial Liabilities Carried at Fair Value
The following table provides information about the Company's financial assets and liabilities carried at fair value. Separate account assets are also recorded at fair value on the Company's Consolidated Balance Sheets and are reported separately in the Separate Accounts section below as gains and losses related to these assets generally accrue directly to contractholders:
(In millions)Quoted Prices in Active Markets for Identical Assets
(Level 1)
Significant Other Observable Inputs
(Level 2)
Significant Unobservable Inputs
(Level 3)
Total
December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021
Financial assets at fair value
Debt securities
Federal government and agency$147 $147 $165 $240 $ $— $312 $387 
State and local government — 41 171  — 41 171 
Foreign government — 365 2,611  365 2,616 
Corporate
 — 8,394 12,606 412 660 8,806 13,266 
Mortgage and other asset-backed — 313 418 35 100 348 518 
Total debt securities147 147 9,278 16,046 447 765 9,872 16,958 
Equity securities (1)
6 16 132 160  31 138 207 
Short-term investments — 139 428  — 139 428 
Derivative assets — 230 143 1 — 231 143 
Financial liabilities at fair value
Derivative liabilities$ $— $ $33 $ $— $ $33 
(1) Excludes certain equity securities that have no readily determinable fair value.
Fair Value and Significant Unobservable Inputs Used in Pricing Debt Securities
The following table summarizes the fair value and significant unobservable inputs that were developed directly by the Company and used in pricing these debt securities. The range and weighted average basis point ("bps") amounts for liquidity reflect the Company's best estimates of the unobservable adjustments a market participant would make to calculate these fair values.
Fair Value as ofUnobservable Adjustment Range (Weighted Average by Quantity) as of
(Fair value in millions)December 31, 2022December 31, 2021Unobservable input December 31, 2022December 31, 2022December 31, 2021
Debt securities
Corporate and government debt securities$412 $664 Liquidity
60 - 1060 (265)
bps
60 - 1060 (410)
bps
Mortgage and other asset-backed securities35 100 Liquidity
105 - 520 (310)
bps
60 - 390 (100)
bps
Other debt securities 
Total Level 3 debt securities$447 $765 
Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value
The following table summarizes the changes in financial assets and financial liabilities classified in Level 3. Gains and losses reported in the table may include net changes in fair value that are attributable to both observable and unobservable inputs.
For the Years Ended December 31,
(In millions)20222021
Debt and Equity Securities
Beginning balance$796 $854 
Gains (losses) included in Shareholders' net income
11 (22)
Losses included in Other comprehensive (loss) income
(59)(6)
Losses required to adjust future policy benefits for settlement annuities (1)
 (8)
Purchases, sales and settlements
Purchases158 138 
Sales (36)
Settlements(207)(119)
Total purchases, sales and settlements(49)(17)
Transfers into/(out of) Level 3
Transfers into Level 3124 207 
Transfers out of Level 3(376)(212)
Total transfers into/(out of) Level 3(252)(5)
Ending balance$447 $796 
Total losses included in Shareholders' net income attributable to instruments held at the reporting date
$(2)$(17)
Change in unrealized gain or (loss) included in Other comprehensive (loss) income for assets held at the end of the reporting period
$(60)$(10)
(1) Amounts do not accrue to shareholders.
Fair Values of Separate Account Assets
Fair values of Separate account assets were as follows:
Quoted Prices in Active Markets for Identical Assets
(Level 1)
Significant Other Observable Inputs
(Level 2)
Significant Unobservable Inputs
(Level 3)
Total
(In millions)December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021December 31, 2022December 31, 2021
Guaranteed separate accounts (See Note 23)
$203 $227 $382 $276 $ $— $585 $503 
Non-guaranteed separate accounts (1)
211 1,130 5,522 6,406 203 334 5,936 7,870 
Subtotal$414 $1,357 $5,904 $6,682 $203 $334 6,521 8,373 
Non-guaranteed separate accounts priced at NAV as a practical expedient (1)
757 842 
Total9,215 
Separate account assets of businesses classified as held for sale (2)
(878)
Separate account assets per Consolidated Balance Sheets$7,278 $8,337 
(1) Non-guaranteed separate accounts include $4.0 billion as of December 31, 2022 and $4.5 billion as of December 31, 2021 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of December 31, 2022 and $0.3 billion as of December 31, 2021.
(2) Investments related to the divested International businesses that were held for sale as of December 31, 2021. See Note 4 for additional information.
Additional Information on Separate Account Assets Priced at NAV
Separate account investments in securities partnerships, real estate and hedge funds are generally valued based on the separate account's ownership share of the equity of the investee (NAV as a practical expedient), including changes in the fair values of its underlying investments. Substantially all of these assets support the Company's pension plans. The following table provides additional information on these investments:
Fair Value as ofUnfunded Commitment as of December 31, 2022Redemption Frequency
(if currently eligible)
Redemption Notice
Period
(In millions)December 31, 2022December 31, 2021
Securities partnerships$451 $513 $249 Not applicableNot applicable
Real estate funds302 325  Quarterly
30 - 90 days
Hedge funds4  Up to annually, varying by fund
30 - 90 days
Total$757 $842 $249 
Fair Value Disclosures for Financial Instruments Not Carried at Fair Value
The following table includes the Company's financial instruments not recorded at fair value but for which fair value disclosure is required. In addition to universal life products and finance leases, financial instruments that are carried in the Company's Consolidated Balance Sheets at amounts that approximate fair value are excluded from the following table:
Classification in Fair Value HierarchyDecember 31, 2022December 31, 2021
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,491 $1,614 $1,598 $1,566 
Long-term debt, including current maturities, excluding finance leasesLevel 2$28,653 $30,994 $35,621 $31,593 
v3.22.4
Collectively Significant Operating Unconsolidated Subsidiaries (Tables)
12 Months Ended
Dec. 31, 2022
Equity Method Investments and Joint Ventures [Abstract]  
Operating Joint Venture Investments
The below summarized results of operations and financial position of the operating joint venture investments accounted for under the equity method reflects the latest available financial information and does not represent the Company's proportionate share of the assets, liabilities or earnings of such entities. The net loss for the year ended December 31, 2022 is primarily attributable to realized investment losses as a result of market volatility experienced by our joint venture in China.
For the Years Ended December 31,
(In millions)202220212020
Revenues$4,208 $3,400 $2,457 
Net (loss) income$(15)$200 $401 
(In millions)December 31, 2022December 31, 2021
Total assets$20,676 $18,942 
Total liabilities$18,441 $16,510 
v3.22.4
Accumulated Other Comprehensive Income (Loss) (Tables)
12 Months Ended
Dec. 31, 2022
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Changes in the Components of AOCI Changes in the components of AOCI were as follows:
For the Years Ended December 31,
(In millions)202220212020
Securities and Derivatives
Beginning balance$685 $900 $975 
Unrealized (depreciation) appreciation on securities and derivatives
(1,528)(230)776 
Tax benefit (expense)
310 31 (150)
Net unrealized (depreciation) appreciation on securities and derivatives
(1,218)(199)626 
Reclassification adjustment for losses (gains) included in Shareholders' net income (Gain on sale of businesses)
172 — (862)
Reclassification adjustment for losses (gains) included in Shareholders' net income (Net realized investment (losses) gains)
52 (21)(26)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net income
(11)187 
Net losses (gains) reclassified from AOCI to Shareholders' net income
213 (16)(701)
Other comprehensive (loss), net of tax
(1,005)(215)(75)
Ending balance$(320)$685 $900 
Translation of foreign currencies
Beginning balance$(233)$(15)$(275)
Translation of foreign currencies(282)(213)232 
Tax (expense) benefit
(33)(19)12 
Net translation of foreign currencies(315)(232)244 
Reclassification adjustment for losses included in Net income (Gain on sale of businesses)
358 — 11 
Reclassification adjustment for tax expense (benefit) included in Net income
29 — (3)
Net translation losses reclassified from AOCI to Net income
387 — 
Other comprehensive income (loss), net of tax
72 (232)252 
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests
(2)(14)(8)
Shareholders' other comprehensive income (loss), net of tax
74 (218)260 
Ending balance$(159)$(233)$(15)
Postretirement benefits liability
Beginning balance$(1,336)$(1,746)$(1,641)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)
65 85 70 
Reclassification adjustment for (gains) included in Shareholders' net income (Gain on sale of businesses)
(1)— — 
Reclassification adjustment for settlement (Interest expense and other)
 — 
Reclassification adjustment for tax (benefit) included in Shareholders' net income
(16)(21)(17)
Net adjustments reclassified from AOCI to Shareholders' net income
48 68 53 
Valuation update487 448 (206)
Tax (expense) benefit
(115)(106)48 
Net change due to valuation update372 342 (158)
Other comprehensive income (loss), net of tax
420 410 (105)
Ending balance$(916)$(1,336)$(1,746)
Total Accumulated other comprehensive loss
Beginning balance$(884)$(861)$(941)
Shareholders' other comprehensive (loss) income, net of tax
(511)(23)80 
Ending balance$(1,395)$(884)$(861)
v3.22.4
Pension (Tables)
12 Months Ended
Dec. 31, 2022
Retirement Benefits [Abstract]  
Summary of the Projected Benefit Obligations and Assets Related to Pension Plans
The following table summarizes the projected benefit obligations and assets related to our U.S. and non-U.S. pension plans:
For the Years Ended December 31,
(In millions)20222021
Change in benefit obligation
Benefit obligation, January 1$5,223 $5,600 
Service cost2 
Interest cost140 132 
Actuarial (gains), net (1)
(1,094)(189)
Benefits paid from plan assets(296)(304)
Other
(27)(18)
Benefit obligation, December 313,948 5,223 
Change in plan assets
Fair value of plan assets, January 14,846 4,623 
Actual return on plan assets(366)522 
Benefits paid(296)(304)
Contributions2 
Fair value of plan assets, December 314,186 4,846 
Funded status$238 $(377)
Amounts presented in Consolidated Balance Sheets
Other assets
$238 $— 
Accrued expenses and other liabilities
$ $(14)
Other non-current liabilities
$ $(363)
(1) 2022 and 2021 gains reflect an increase in the discount rate.
Benefit Payments The following benefit payments are expected to be paid in:
(In millions)
2023$320 
2024$316 
2025$316 
2026$316 
2027$313 
2028 - 2032$1,508 
Postretirement Benefits Liability Adjustment Included in AOCI Amounts reflected in the pension assets/(liabilities) shown above that have not yet been reported in Net income and, therefore, have been included in Accumulated other comprehensive loss consisted of the following:
(In millions)December 31, 2022December 31, 2021
Unrecognized net (losses)
$(1,208)$(1,753)
Unrecognized prior service cost(5)(5)
Postretirement benefits liability adjustment$(1,213)$(1,758)
Components of Net Pension Cost Net pension cost was as follows:
For the Years Ended December 31,
(In millions)202220212020
Service cost$2 $$
Interest cost140 132 168 
Expected long-term return on plan assets(272)(269)(260)
Amortization of:
Prior actuarial losses, net89 78 78 
Settlement loss — 
Net (benefit) cost$(41)$(53)$(12)
Assumptions Used for Pension
For the Years Ended December 31,
 20222021
Discount rate:
Pension benefit obligation5.43%2.82%
Pension benefit cost2.82%2.49%
Expected long-term return on plan assets:
Pension benefit cost6.75%6.75%
Mortality table for pension obligationsWhite Collar mortality table with MP 2021 projection scaleWhite Collar mortality table with MP 2021 projection scale
Fair Value of Pension Assets by Category
The fair values of pension assets by category are as follows:
(In millions)December 31, 2022December 31, 2021
Debt securities:
Federal government and agency$11 $
Corporate2,349 1,653 
Asset-backed109 108 
Fund investments478 731 
Total debt securities2,947 2,501 
Equity securities:
Domestic89 789 
International, including funds and pooled separate accounts (1)
35 358 
Total equity securities124 1,147 
Securities partnerships452 514 
Real estate funds, including pooled separate accounts (1)
315 334 
Commercial mortgage loans63 77 
Hedge funds — 
Guaranteed deposit account contract50 91 
Cash equivalents and other current assets, net235 182 
Total pension assets at fair value$4,186 $4,846 
(1) A pooled separate account has several participating benefit plans and each owns a share of the total pool of investments.
Annual Expense for 401(k) Plans The Company's annual expense for the plan was as follows:
For the Years Ended December 31,
(In millions)202220212020
Expense$274 $268 $243 
v3.22.4
Employee Incentive Plans (Tables)
12 Months Ended
Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]  
Shares of Common Stock Available for Award Shares of common stock available for award were as follows:
(In millions)December 31, 2022December 31, 2021December 31, 2020
Common shares available for award16.6 19.1 20.6 
Black-Sholes Option-Pricing Model Assumptions Black-Scholes option-pricing model assumptions and the resulting fair value of options are presented in the following table:
 202220212020
Dividend yield1.98 %1.85 %— %
Expected volatility30.0 %30.0 %30.0 %
Risk-free interest rate1.6 %0.5 %1.4 %
Expected option life4.5 years4.5 years4.5 years
Weighted average fair value of options$50.61 $44.84 $52.42 
Status of and Changes in Common Stock Options The following table shows the status of, and changes in, common stock options:
For the Years Ended December 31,
202220212020
(Options in thousands)OptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise Price
Outstanding - January 18,490 $169.47 9,742 $152.40 11,438 $136.19 
Granted1,375 $226.95 1,524 $213.81 1,851 $191.86 
Exercised(2,617)$149.97 (2,584)$129.08 (3,289)$115.38 
Expired or canceled(256)$211.22 (192)$199.10 (258)$188.79 
Outstanding - December 316,992 $186.54 8,490 $169.47 9,742 $152.40 
Options exercisable at year-end4,410 $168.97 5,612 $152.92 6,837 $137.08 
Summary of Information for Stock Options Exercised and Outstanding
The table below summarizes information for stock options exercised:
For the Years Ended December 31,
(In millions)202220212020
Intrinsic value of options exercised$313 $268 $304 
Cash received for options exercised$389 $326 $376 
Tax benefit from options exercised$47 $50 $57 
The following table summarizes information for outstanding common stock options:
December 31, 2022
 Options
Outstanding
Options
Exercisable
Number (in thousands)6,992 4,410 
Total intrinsic value (in millions)$1,012 $716 
Weighted average exercise price$186.54 $168.97 
Weighted average remaining contractual life6.2 years4.9 years
Status of and Changes in Restricted Stock Awards and the Fair Value of Vested Restricted Stock
The following table shows the status of, and changes in, restricted stock awards:
For the Years Ended December 31,
202220212020
(Awards in thousands)Grants/UnitsWeighted Average Fair Value at Award DateGrants/UnitsWeighted Average Fair Value at Award DateGrants/UnitsWeighted Average Fair Value at Award Date
Outstanding - January 11,524 $202.85 1,600 $186.12 1,945 $178.78 
Awarded876 $229.60 899 $213.82 791 $191.22 
Vested(714)$197.83 (866)$184.07 (1,026)$161.58 
Forfeited(151)$215.02 (109)$197.01 (110)$186.63 
Outstanding - December 311,535 $219.25 1,524 $202.85 1,600 $186.12 
The fair value of vested restricted stock at the vesting date was as follows:
For the Years Ended December 31,
(In millions)202220212020
Fair value of vested restricted stock$167 $183 $190 
Status of and Changes in SPSs The following table shows the status of, and changes in, SPSs:
For the Years Ended December 31,
 202220212020
(Awards in thousands)SharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award Date
Outstanding - January 1860 $197.07 808 $190.02 818 $177.94 
Awarded294 $230.69 331 $213.90 362 $191.52 
Vested(261)$183.60 (206)$196.29 (309)$159.67 
Forfeited(113)$207.75 (73)$197.38 (63)$187.76 
Outstanding - December 31780 $212.68 860 $197.07 808 $190.02 
The fair value of vested SPSs at the vesting date was as follows:
For the Years Ended December 31,
 202220212020
(Shares in thousands; $ in millions)SharesFair ValueSharesFair ValueSharesFair Value
Shares of The Cigna Group common stock distributed upon SPS vesting137 $31 243 $51 306 $55 
Compensation Cost and Tax Effects of Share-based Compensation Compensation Cost and Tax Effects of Share-based CompensationThe Company records tax benefits in Shareholders' net income during the vesting period based on the amount of expense being recognized. The difference between tax benefits based on the expense and the actual tax benefit realized are also recorded in Net income when stock options are exercised, or when restricted stock and SPSs vest.
For the Years Ended December 31,
(In millions)202220212020
Total compensation cost for shared-based awards$264 $268 $289 
Tax benefits recognized$80 $73 $63 
v3.22.4
Goodwill, Other Intangibles and Property and Equipment (Tables)
12 Months Ended
Dec. 31, 2022
Goodwill Other Intangibles And Property And Equipment [Abstract]  
Goodwill Activity Goodwill activity. Goodwill activity was as follows:
(In millions)Evernorth Health ServicesCigna HealthcareOther OperationsTotal
Balance at January 1, 2021
$33,806 $10,577 $265 $44,648 
Goodwill acquired1,322 116 — 1,438 
Goodwill disposed— (10)— (10)
Impact of foreign currency translation and other adjustments— — (31)(31)
Goodwill at December 31, 2021 (1)
35,128 10,683 234 46,045 
Goodwill disposed  (234)(234)
Impact of foreign currency translation and other adjustments2 (2)  
Goodwill at December 31, 2022
$35,130 $10,681 $ $45,811 
(1) Includes $234 million classified as Assets of businesses held for sale, all reported within Other Operations.
Other Indefinite-Lived Intangible Assets Other intangible assets were comprised of the following:
(In millions)CostAccumulated AmortizationNet Carrying Value
December 31, 2022   
Customer relationships$29,974 6,099 23,875 
Trade Name - Express Scripts8,400 8,400 
Other348 131 217 
Other intangible assets38,722 6,230 32,492 
Value of business acquired ("VOBA" reported in Other assets)
210 133 77 
Total $38,932 6,363 32,569 
December 31, 2021
Customer relationships$29,997 4,539 25,458 
Trade Name - Express Scripts8,400 8,400 
Other447 81 366 
Other intangible assets38,844 4,620 34,224 
Value of business acquired (reported in Other assets)
646 171 475 
Total (1)
$39,490 4,791 34,699 
(1) Includes $386 million of VOBA and $122 million of Other intangible assets intangible assets classified as Assets of businesses held for sale.
Other Finite-Lived Intangible Assets Other intangible assets were comprised of the following:
(In millions)CostAccumulated AmortizationNet Carrying Value
December 31, 2022   
Customer relationships$29,974 6,099 23,875 
Trade Name - Express Scripts8,400 8,400 
Other348 131 217 
Other intangible assets38,722 6,230 32,492 
Value of business acquired ("VOBA" reported in Other assets)
210 133 77 
Total $38,932 6,363 32,569 
December 31, 2021
Customer relationships$29,997 4,539 25,458 
Trade Name - Express Scripts8,400 8,400 
Other447 81 366 
Other intangible assets38,844 4,620 34,224 
Value of business acquired (reported in Other assets)
646 171 475 
Total (1)
$39,490 4,791 34,699 
(1) Includes $386 million of VOBA and $122 million of Other intangible assets intangible assets classified as Assets of businesses held for sale.
Property and Equipment Property and equipment was comprised of the following:
(In millions)CostAccumulated AmortizationNet Carrying Value
December 31, 2022   
Internal-use software$8,948 $6,100 $2,848 
Other property and equipment2,256 1,330 926 
Total property and equipment$11,204 $7,430 $3,774 
December 31, 2021
Internal-use software$7,869 $5,060 $2,809 
Other property and equipment2,839 1,653 1,186 
Total10,708 6,713 3,995 
Property and equipment classified as Assets of businesses held for sale
(424)(121)(303)
Total Property and equipment per Consolidated Balance Sheets$10,284 $6,592 $3,692 
Components of Depreciation and Amortization Expense Depreciation and amortization expense was comprised of the following:
For the Years Ended December 31,
(In millions)202220212020
Internal-use software$1,068 $1,097 $971 
Other property and equipment251 253 276 
Value of business acquired (reported in Other assets)
12 25 28 
Other intangibles1,606 1,548 1,527 
Total depreciation and amortization$2,937 $2,923 $2,802 
Estimated Annual Pre-Tax Amortization for Intangible Assets The Company estimates annual pre-tax amortization for intangible assets, including internal-use software, over the next five calendar years to be as follows:
(In millions)Pre-tax Amortization
2023$2,804 
2024$2,302 
2025$1,988 
2026$1,583 
2027$1,523 
v3.22.4
Leases (Tables)
12 Months Ended
Dec. 31, 2022
Leases [Abstract]  
Operating and Finance Lease Right of Use ("ROU") Assets and Lease Liabilities ROU assets and lease liabilities are reflected in the following lines in the Company's Consolidated Balance Sheets:
  ROU Asset Current Lease Liability Non-Current Lease Liability
Operating lease Other assets Accrued expenses and other liabilities (current) Other liabilities (non-current)
Finance lease Property and equipment Short-term debt Long-term debt
Operating and finance lease right-of-use ("ROU") assets and lease liabilities were as follows:
(In millions)December 31, 2022December 31, 2021
Operating leases: (1)
Operating lease ROU assets in Other assets
$375 $478 
Accrued expenses and other liabilities$114 $159 
Other non-current liabilities346 436 
Total operating lease liabilities$460 $595 
Finance leases:
Property and equipment, gross$145 $101 
Accumulated depreciation(48)(51)
Property and equipment, net$97 $50 
Short-term debt$33 $23 
Long-term debt66 28 
Total finance lease liabilities$99 $51 
(1) Operating leases include $27 million as of December 31, 2021 classified as Assets of businesses held for sale and $28 million as of December 31, 2021 classified as Liabilities of businesses held for sale.
Components of Lease Expense The components of lease expense were as follows:
For the Years Ended December 31,
(In millions)202220212020
Operating lease cost$124 $170 $190 
Finance lease cost:
Amortization of ROU assets33 22 28 
Interest on lease liabilities2 
Total finance lease cost35 24 31 
Variable lease cost41 39 48 
Total lease cost$200 $233 $269 
Supplemental Cash Flow Information Related to Leases Supplemental cash flow information related to leases was as follows:
For the Years Ended December 31,
(In millions)202220212020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$148 $167 $189 
Operating cash outflows from finance leases$2 $$
Financing cash outflows from finance leases$33 $22 $26 
 
ROU assets obtained in exchange for lease obligations:
Operating leases$43 $122 $189 
Finance leases$84 $20 $
Maturities of Operating Lease Liabilities Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2023$114 $35 
2024111 31 
202584 24 
202664 10 
202747 3 
Thereafter74 2 
Total lease payments494 105 
Less: imputed interest34 6 
Total$460 $99 
Maturities of Finance Lease Liabilities Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2023$114 $35 
2024111 31 
202584 24 
202664 10 
202747 3 
Thereafter74 2 
Total lease payments494 105 
Less: imputed interest34 6 
Total$460 $99 
v3.22.4
Shareholders Equity and Dividend Restrictions (Tables)
12 Months Ended
Dec. 31, 2022
Equity [Abstract]  
Statutory Net Income and Net Assets of the Company's Subsidiaries The statutory net income of the Company's life, accident and health insurance and HMO subsidiaries for the years ended, and their statutory surplus as of December 31 were as follows:
(In billions)202220212020
Net income$5.7 $3.4 $4.0 
Surplus$16.4 $13.3 $12.9 
These amounts, including restricted GAAP net assets of the Company's subsidiaries, were as follows:
(In billions)December 31, 2022
Minimum statutory surplus required by regulators (1)
$4.2 
Investments on deposit with regulatory bodies$0.3 
Maximum dividend distributions permitted in 2023 without regulatory approval
$3.2 
Maximum loans to the parent company permitted without regulatory approval$1.4 
Restricted GAAP net assets of The Cigna Group's subsidiaries$14.8 
(1) Excludes amounts associated with foreign operated equity method joint ventures.
v3.22.4
Income Taxes (Tables)
12 Months Ended
Dec. 31, 2022
Income Tax Disclosure [Abstract]  
Components of Income Tax Expense The components of income taxes were as follows:
For the Years Ended December 31,
(In millions)202220212020
Current taxes
U.S. income taxes$1,679 $1,268 $2,128 
Foreign income taxes219 207 334 
State income taxes189 112 303 
Total current taxes2,087 1,587 2,765 
Deferred taxes (benefits)
U.S. income tax benefits
(283)(167)(217)
Foreign income (tax benefits) taxes
(28)69 11 
State income tax benefits
(169)(122)(180)
Total deferred tax benefits
(480)(220)(386)
Total income taxes$1,607 $1,367 $2,379 
Reconciliation of Total Income Taxes to the Amount Computed Using the Nominal Federal Income Tax Rate Total income taxes were different from the amount computed using the nominal federal income tax rate for the following reasons:
For the Years Ended December 31,
 202220212020
(In millions)$%$%$%
Tax expense at nominal rate$1,754 21.0 %$1,424 21.0 %$2,282 21.0 %
Impact of sale of businesses(37)(0.4)— — 104 1.0 
Effect of foreign earnings(96)(1.2)(33)(0.5)(61)(0.6)
Health insurance industry tax  — — 93 0.9 
State income tax (benefit), net of federal income tax benefit
16 0.2 (9)(0.1)24 0.2 
Other(30)(0.4)(15)(0.2)(63)(0.6)
Total income taxes$1,607 19.2 %$1,367 20.2 %$2,379 21.9 %
Deferred Income Tax Assets and Liabilities Deferred income tax assets and liabilities were as follows:
(In millions)December 31, 2022December 31, 2021
Deferred tax assets
Employee and retiree benefit plans$189 $304 
Other insurance and contractholder liabilities311 263 
Loss carryforwards205 278 
Other accrued liabilities265 412 
Policy acquisition expenses41 — 
Unrealized depreciation on investments and foreign currency translation156 — 
Other190 246 
Deferred tax assets before valuation allowance1,357 1,503 
Valuation allowance for deferred tax assets(208)(246)
Deferred tax assets, net of valuation allowance1,149 1,257 
Deferred tax liabilities
Depreciation and amortization512 698 
Acquisition-related basis differences8,347 8,726 
Policy acquisition expenses 312 
Unrealized appreciation on investments and foreign currency translation 104 
Other41 212 
Total deferred tax liabilities8,900 10,052 
Net deferred income tax liabilities
(8,795)
Net deferred income tax liabilities classified as Liabilities of businesses held for sale
(449)
Net deferred income tax liabilities per Consolidated Balance Sheets
$(7,751)$(8,346)
Reconciliations of Unrecognized Tax Benefits Reconciliations of unrecognized tax benefits were as follows:
For the Years Ended December 31,
(In millions)202220212020
Balance at January 1,$1,230 $1,210 $1,018 
Increase due to prior year positions8 21 128 
Increase due to current year positions137 31 88 
Reduction related to settlements with taxing authorities(4)(15)— 
Reduction related to lapse of applicable statute of limitations(28)(17)(24)
Balance at December 31,$1,343 $1,230 $1,210 
v3.22.4
Segment Information (Tables)
12 Months Ended
Dec. 31, 2022
Segment Reporting [Abstract]  
Summary of Special Items
The following table presents the special items charges (benefits) recorded by the Company, as well as the respective financial statement line items impacted:
For the Years Ended December 31,
202220212020
(In millions)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Integration and transaction-related costs
 (Selling, general and administrative expenses)
$135 $103 $169 $71 $527 $404 
Charge for organizational efficiency plan
 (Selling, general and administrative expenses)
22 17 168 119 31 24 
(Benefits) charges associated with litigation matters
 (Selling, general and administrative expenses)
(28)(20)(27)(21)25 19 
(Gain) on sale of businesses(1,662)(1,332)— — (4,203)(3,217)
Debt extinguishment costs   141 110 199 151 
Risk corridors recovery
 (Selling, general and administrative expenses)
  — — (101)(76)
Contractual adjustment for a former client
 (Pharmacy revenues)
  — — (204)(155)
Total impact from special items$(1,533)$(1,232)$451 $279 $(3,726)$(2,850)
Summarized Segment Financial Information Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2022
Revenues from external customers$135,786 $41,737 $1,838 $ $179,361 
Intersegment revenues4,463 2,535  (6,998)
Net investment income
86 638 424 7 1,155 
Total revenues140,335 44,910 2,262 (6,991)180,516 
Net realized investment results from certain equity method investments
 126   126 
Adjusted revenues$140,335 $45,036 $2,262 $(6,991)$180,642 
Depreciation and amortization$2,283 $638 $6 $10 $2,937 
Income (loss) before income taxes
$4,421 $3,443 $2,084 $(1,595)$8,353 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(66)(4)(14) (84)
Net realized investment losses (1)
 530 91  621 
Amortization of acquired intangible assets1,772 103 1  1,876 
Special items
Integration and transaction-related costs   135 135 
Charge for organizational efficiency plan   22 22 
(Benefits) associated with litigation matters   (28)(28)
(Gain) on sale of businesses  (1,662) (1,662)
Pre-tax adjusted income (loss) from operations$6,127 $4,072 $500 $(1,466)$9,233 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2021
Revenues from external customers
$127,692 $41,378 $3,459 $— $172,529 
Intersegment revenues4,203 2,271 — (6,474)
Net investment income (loss)
17 1,003 530 (1)1,549 
Total revenues131,912 44,652 3,989 (6,475)174,078 
Net realized investment results from certain equity method investments— — — — — 
Adjusted revenues$131,912 $44,652 $3,989 $(6,475)$174,078 
Depreciation and amortization$2,316 $551 $52 $$2,923 
Income (loss) before income taxes
$3,908 $3,812 $852 $(1,790)$6,782 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(31)(3)(24)— (58)
Net realized investment losses (gains) (1)
(247)47 — (196)
Amortization of acquired intangible assets1,937 47 14 — 1,998 
Special items
Integration and transaction-related costs   169 169 
Charge for organizational efficiency plan   168 168 
(Benefits) associated with litigation matters —  (27)(27)
Debt extinguishment costs  —  141 141 
Pre-tax adjusted income (loss) from operations$5,818 $3,609 $889 $(1,339)$8,977 
(1) Includes the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2020
Revenues from external customers$112,647 $38,826 $7,684 $— $159,157 
Intersegment revenues3,655 1,966 23 (5,644)
Net investment income
32 473 739 — 1,244 
Total revenues116,334 41,265 8,446 (5,644)160,401 
Net realized investment results from certain equity method investments— (130)— — (130)
Special item related to contractual adjustment for a former client(204)— — — (204)
Adjusted revenues$116,130 $41,135 $8,446 $(5,644)$160,067 
Depreciation and amortization$2,248 $458 $71 $25 $2,802 
Income (loss) before income taxes
$3,684 $4,291 $5,227 $(2,334)$10,868 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(17)(1)(19)— (37)
Net realized investment (gains) (1)
(17)(202)(60)— (279)
Amortization of acquired intangible assets1,917 44 21 — 1,982 
Special items
Integration and transaction-related costs— — — 527 527 
Charge for organizational efficiency plan— — — 31 31 
Charges associated with litigation matters— — — 25 25 
(Gain) on sale of businesses— — (4,203)— (4,203)
Debt extinguishment costs — — — 199 199 
Risk corridors recovery — (101)— — (101)
Contractual adjustment for a former client (204)— — — (204)
Pre-tax adjusted income (loss) from operations$5,363 $4,031 $966 $(1,552)$8,808 
(1) Includes the Company's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.
Revenue from External Customers Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:
For the Years Ended December 31,
(In millions)202220212020
Products (Pharmacy revenues) (ASC 606)
Network revenues$64,946 $64,992 $56,365 
Home delivery and specialty revenues61,283 54,391 49,906 
Other revenues6,753 6,428 5,403 
Intercompany eliminations(4,416)(4,398)(3,905)
Total pharmacy revenues128,566 121,413 107,769 
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Commercial
Insured15,199 14,315 13,389 
Stop loss5,461 4,868 4,614 
Other1,418 1,290 1,135 
U.S. Government
Medicare Advantage7,896 8,362 7,565 
Medicare Part D1,224 1,499 1,593 
Other3,990 4,815 4,301 
International Health2,906 2,588 2,472 
Total Cigna Healthcare38,094 37,737 35,069 
Divested International businesses1,596 3,205 3,039 
Domestic disability, life and accident — 4,423 
Other224 221 124 
Intercompany eliminations1 (9)(28)
Total premiums39,915 41,154 42,627 
Services (Fees) (ASC 606)
Evernorth Health Services
7,234 6,070 4,611 
Cigna Healthcare
6,053 5,743 5,491 
Other Operations
9 19 116 
Other revenues167 197 254 
Intercompany eliminations(2,583)(2,067)(1,711)
Total fees and other revenues10,880 9,962 8,761 
Total revenues from external customers$179,361 $172,529 $159,157 
Foreign and U.S. Revenues from External Customers
U.S. and foreign revenues from external customers are shown below. The Company's foreign revenues are generated by its foreign operating entities. In the periods shown, no single foreign country contributed more than 2% of consolidated revenues from external customers.
For the Years Ended December 31,
(In millions)202220212020
United States$174,539 $166,626 $154,042 
Foreign countries (1)
4,822 5,903 5,115 
Total$179,361 $172,529 $159,157 
(1) The divested International businesses as described in Note 4 comprised $1.6 billion, $3.2 billion and $3.1 billion in 2022, 2021 and 2020, respectively.
v3.22.4
Description of Business (Details)
$ in Billions
Jul. 01, 2022
USD ($)
International life, accident, supplemental benefits businesses sold to Chubb | Disposed of by Sale  
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]  
Sale price $ 5.4
v3.22.4
Summary of Significant Accounting Policies (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Amortization of deferred policy acquisition costs $ 319 $ 478 $ 502
Pharmacy Benefits Management Services | Guarantees      
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Performance guarantee liability 1,300 1,100  
Administrative Services Only Health Care Services | Performance Guarantee      
New Accounting Pronouncements or Change in Accounting Principle [Line Items]      
Loss contingency accrual provision
Amounts paid for loss contigency
v3.22.4
Accounts Receivable, Net - Summary of Accounts Receivable, Net (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Receivables [Abstract]    
Pharmaceutical manufacturers receivables $ 7,108  
Noninsurance customer receivables 6,899  
Insurance customer receivables 2,963  
Other receivables 248  
Pharmaceutical manufacturers receivable, including held for sale assets   $ 5,463
Noninsurance customer receivables, including held for sale assets   6,274
Insurance customer receivables, including held for sale assets   2,932
Other receivables, including held for sale assets   456
Total   15,125
Accounts receivable, net classified as Assets of businesses held for sale   (54)
Accounts receivable, net per Consolidated Balance Sheets $ 17,218 $ 15,071
v3.22.4
Accounts Receivable, Net - Narrative (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Receivables [Abstract]    
Allowance for receivables, current $ 1,900 $ 1,400
Pharmaceutical manufacturers receivables allowance 1,300 926
Noninsurance customer receivables allowance 336 321
Remaining allowances 226 186
Allowance for current expected credit losses on accounts receivable $ 86 $ 60
v3.22.4
Mergers, Acquisitions and Divestitures - Narrative (Details) - USD ($)
$ in Millions
12 Months Ended
Jul. 01, 2022
Dec. 31, 2020
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]          
Gain (loss) on sale of business, location not disclosed     gain    
Integration and transaction-related costs, pre-tax     $ 135 $ 169 $ 527
Integration and transaction-related costs, after-tax     $ 103 $ 71 $ 404
U.S Group Disability and Life Insurance | Disposed of by Sale          
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]          
Cash proceeds from sale of business   $ 6,200      
Gain (loss) on sale of business, pre-tax   4,200      
Gain (loss) on sale of business, after-tax   $ 3,200      
International life, accident, supplemental benefits businesses sold to Chubb | Disposed of by Sale          
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]          
Sale price $ 5,400        
Gain (loss) on sale of business, pre-tax 1,700        
Gain (loss) on sale of business, after-tax $ 1,400        
v3.22.4
Assets and Liabilities of Businesses Held for Sale (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Jul. 01, 2022
Dec. 31, 2021
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Separate account assets     $ 878
Assets of businesses held for sale $ 0   10,057
Insurance and contractholder liabilities     4,644
Deferred tax liabilities, net     449
Total liabilities of businesses held for sale $ 0   6,423
International life, accident and supplemental benefits businesses | Held-for-Sale      
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Cash and cash equivalents     406
Investments     5,109
Deferred policy acquisition costs     2,755
Separate account assets     878
Goodwill, other intangible assets and all other assets     909
Assets of businesses held for sale     10,057
Insurance and contractholder liabilities     4,644
Accounts payable, accrued expenses and other liabilities     452
Deferred tax liabilities, net     449
Separate account liabilities     878
Total liabilities of businesses held for sale     6,423
Gross unrealized appreciation on securities and derivatives     137
Gross translation loss on foreign currencies     $ 209
International life, accident, supplemental benefits businesses sold to Chubb | Disposed of by Sale      
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Sale price   $ 5,400  
v3.22.4
Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Earnings Per Share [Abstract]      
Shareholders' net income $ 6,668 $ 5,365 $ 8,458
Shares:      
Weighted average (in shares) 309,546 337,962 364,979
Common stock equivalents (in shares) 3,519 3,004 3,410
Total shares (in shares) 313,065 340,966 368,389
EPS, basic (in dollars per share) $ 21.54 $ 15.87 $ 23.17
EPS, effect of dilution (in dollars per share) (0.24) (0.14) (0.21)
EPS, diluted (in dollars per share) $ 21.30 $ 15.73 $ 22.96
v3.22.4
Earnings Per Share - Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share (Details) - shares
shares in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Employee Stock Options      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Antidilutive options (in shares) 1.0 1.5 4.1
v3.22.4
Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)
Jan. 15, 2023
Dec. 31, 2022
Dec. 31, 2021
Short-term debt      
Commercial paper   $ 0 $ 2,027,000,000
Other, including finance leases   33,000,000 23,000,000
Total short-term debt   2,993,000,000 2,545,000,000
Long-term debt      
Other, including finance leases   66,000,000 28,000,000
Total long-term debt   28,100,000,000 31,125,000,000
$500 million, 3.05% Notes due November 2022      
Short-term debt      
Current maturities   0 495,000,000
Long-term debt      
Gross value   $ 500,000,000  
Interest Rate   3.05%  
$17 million, 8.3% Notes due January 2023      
Short-term debt      
Current maturities   $ 17,000,000 0
Long-term debt      
Long-term debt   0 17,000,000
Gross value   $ 17,000,000  
Interest Rate   8.30%  
$63 million, 7.65% Notes due March 2023      
Short-term debt      
Current maturities   $ 63,000,000 0
Long-term debt      
Long-term debt   0 63,000,000
Gross value   $ 63,000,000  
Interest Rate   7.65%  
$700 million, Floating Rate Notes due July 2023      
Short-term debt      
Current maturities   $ 700,000,000 0
Long-term debt      
Long-term debt   0 699,000,000
Gross value   700,000,000  
$1,000 million, 3% Notes due July 2023      
Short-term debt      
Current maturities   994,000,000 0
Long-term debt      
Long-term debt   0 985,000,000
Gross value   $ 1,000,000,000  
Interest Rate   3.00%  
$1,187 million, 3.75% Notes due July 2023      
Short-term debt      
Current maturities   $ 1,186,000,000 0
Long-term debt      
Long-term debt   0 1,185,000,000
Gross value   $ 1,187,000,000  
Interest Rate   3.75%  
$500 million, 0.613% Notes due March 2024      
Long-term debt      
Long-term debt   $ 499,000,000 498,000,000
Gross value   $ 500,000,000  
Interest Rate   0.613%  
$1,000 million, 3.5% Notes due June 2024      
Long-term debt      
Long-term debt   $ 990,000,000 983,000,000
Gross value   $ 1,000,000,000  
Interest Rate   3.50%  
$900 million, 3.25% Notes due April 2025 (1)      
Long-term debt      
Long-term debt   $ 872,000,000 897,000,000
Gross value   $ 900,000,000  
Interest Rate   3.25%  
$2,200 million, 4.125% Notes due November 2025      
Long-term debt      
Long-term debt   $ 2,195,000,000 2,193,000,000
Gross value   $ 2,200,000,000  
Interest Rate   4.125%  
$1,500 million, 4.5% Notes due February 2026      
Long-term debt      
Long-term debt   $ 1,503,000,000 1,504,000,000
Gross value   $ 1,500,000,000  
Interest Rate   4.50%  
$800 million, 1.25% Notes due March 2026      
Long-term debt      
Long-term debt   $ 797,000,000 796,000,000
Gross value   $ 800,000,000  
Interest Rate   1.25%  
$1,500 million, 3.4% Notes due March 2027      
Long-term debt      
Long-term debt   $ 1,436,000,000 1,423,000,000
Gross value   $ 1,500,000,000  
Interest Rate   3.40%  
$259 million, 7.875% Debentures due May 2027      
Long-term debt      
Long-term debt   $ 259,000,000 259,000,000
Gross value   $ 259,000,000  
Interest Rate   7.875%  
$600 million, 3.05% Notes due October 2027      
Long-term debt      
Long-term debt   $ 597,000,000 596,000,000
Gross value   $ 600,000,000  
Interest Rate   3.05%  
$3,800 million, 4.375% Notes due October 2028      
Long-term debt      
Long-term debt   $ 3,785,000,000 3,782,000,000
Gross value   $ 3,800,000,000  
Interest Rate   4.375%  
$1,500 million, 2.4% Notes due March 2030      
Long-term debt      
Long-term debt   $ 1,492,000,000 1,490,000,000
Gross value   $ 1,500,000,000  
Interest Rate   2.40%  
$1,500 million, 2.375% Notes due 2031      
Long-term debt      
Long-term debt   $ 1,380,000,000 1,500,000,000
Gross value   $ 1,500,000,000  
Interest Rate   2.375%  
$45 million, 8.3% Step Down Notes due January 2033 (2)      
Long-term debt      
Long-term debt   $ 45,000,000 45,000,000
Gross value   $ 45,000,000  
Interest Rate   8.30%  
$45 million, 8.3% Step Down Notes due January 2033 (2) | Subsequent Event      
Long-term debt      
Interest Rate 8.08%    
$190 million, 6.15% Notes due November 2036      
Long-term debt      
Long-term debt   $ 190,000,000 190,000,000
Gross value   $ 190,000,000  
Interest Rate   6.15%  
$2,200 million, 4.8% Notes due August 2038      
Long-term debt      
Long-term debt   $ 2,192,000,000 2,192,000,000
Gross value   $ 2,200,000,000  
Interest Rate   4.80%  
$750 million, 3.2% Notes due March 2040      
Long-term debt      
Long-term debt   $ 743,000,000 743,000,000
Gross value   $ 750,000,000  
Interest Rate   3.20%  
$121 million, 5.875% Notes due March 2041      
Long-term debt      
Long-term debt   $ 119,000,000 119,000,000
Gross value   $ 121,000,000  
Interest Rate   5.875%  
$448 million, 6.125% Notes due November 2041      
Long-term debt      
Long-term debt   $ 488,000,000 490,000,000
Gross value   $ 448,000,000  
Interest Rate   6.125%  
$317 million, 5.375% Notes due February 2042      
Long-term debt      
Long-term debt   $ 315,000,000 315,000,000
Gross value   $ 317,000,000  
Interest Rate   5.375%  
$1,500 million, 4.8% Notes due July 2046      
Long-term debt      
Long-term debt   $ 1,466,000,000 1,465,000,000
Gross value   $ 1,500,000,000  
Interest Rate   4.80%  
$1,000 million, 3.875% Notes due October 2047      
Long-term debt      
Long-term debt   $ 989,000,000 988,000,000
Gross value   $ 1,000,000,000  
Interest Rate   3.875%  
$3,000 million, 4.9% Notes due December 2048      
Long-term debt      
Long-term debt   $ 2,968,000,000 2,967,000,000
Gross value   $ 3,000,000,000  
Interest Rate   4.90%  
$1,250 million, 3.4% Notes due March 2050      
Long-term debt      
Long-term debt   $ 1,236,000,000 1,236,000,000
Gross value   $ 1,250,000,000  
Interest Rate   3.40%  
$1,500 million, 3.4% Notes due March 2051      
Long-term debt      
Long-term debt   $ 1,478,000,000 $ 1,477,000,000
Gross value   $ 1,500,000,000  
Interest Rate   3.40%  
v3.22.4
Debt - Debt Issuances and Redemptions (Details) - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Mar. 03, 2021
Debt Instrument [Line Items]        
Aggregate principal amount of outstanding debt securities redeemed   $ 4,500,000,000    
Loss on repurchase of debt, pre-tax $ 0 141,000,000 $ 199,000,000  
Loss on repurchase of debt, after-tax   $ 110,000,000    
Senior Notes        
Debt Instrument [Line Items]        
Principal       $ 4,300,000,000
$500 million, 0.613% Notes due March 2024        
Debt Instrument [Line Items]        
Interest rate 0.613%      
$800 million, 1.25% Notes due March 2026        
Debt Instrument [Line Items]        
Interest rate 1.25%      
$1,500 million, 2.375% Notes due 2031        
Debt Instrument [Line Items]        
Interest rate 2.375%      
$1,500 million, 3.4% Notes due March 2051        
Debt Instrument [Line Items]        
Interest rate 3.40%      
v3.22.4
Debt - Maturities of Outstanding Long-Term Debt (Details)
$ in Millions
Dec. 31, 2022
USD ($)
Long-term Debt  
2023 $ 2,967
2024 1,500
2025 3,100
2026 2,300
2027 2,359
Maturities after 2027 $ 19,122
v3.22.4
Debt - Narrative (Details)
1 Months Ended 12 Months Ended
Apr. 30, 2022
USD ($)
bank
Apr. 30, 2021
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Debt Instrument [Line Items]          
Interest expense on long-term and short-term debt     $ 1,300,000,000 $ 1,300,000,000 $ 1,400,000,000
Commercial Paper          
Debt Instrument [Line Items]          
Outstanding balances     0    
Maximum borrowing capacity     5,000,000,000    
Revolving Credit And Letter Of Credit Facility Maturing April 2027, Revolving Credit Facility Maturing April 2025, And 364 Day Revolving Credit Agreement, Maturing April 2023          
Debt Instrument [Line Items]          
Outstanding balances     $ 0    
Aggregate amount of options to increase commitments $ 1,500,000,000        
Maximum total commitment $ 6,500,000,000        
Number of participating banks | bank 22        
Leverage ratio covenant 60.00%        
Revolving Credit And Letter Of Credit Facility Maturing April 2027          
Debt Instrument [Line Items]          
Maximum borrowing capacity $ 3,000,000,000        
Credit agreement term 5 years        
Credit agreement extension term 1 year        
Revolving Credit And Letter Of Credit Facility Maturing April 2027 | Letter of Credit          
Debt Instrument [Line Items]          
Maximum borrowing capacity $ 500,000,000        
Revolving Credit Facility Maturing April 2025          
Debt Instrument [Line Items]          
Maximum borrowing capacity $ 1,000,000,000        
Credit agreement term 3 years        
Credit agreement extension term 1 year        
364 Day Revolving Credit Agreement, Maturing April 2023          
Debt Instrument [Line Items]          
Maximum borrowing capacity $ 1,000,000,000        
Credit agreement term 364 days        
Credit facility, conversion to term loan, term 1 year        
Five-year Revolving Credit Agreement, Maturing April 2026          
Debt Instrument [Line Items]          
Maximum borrowing capacity   $ 3,000,000,000      
Credit agreement term   5 years      
Three-year Revolving Credit Agreement, Maturing April 2024          
Debt Instrument [Line Items]          
Maximum borrowing capacity   $ 1,000,000,000      
Credit agreement term   3 years      
364-day Revolving Credit Agreement, Maturing April 2022          
Debt Instrument [Line Items]          
Maximum borrowing capacity   $ 1,000,000,000      
Credit agreement term   364 days      
v3.22.4
Common and Preferred Stock - Share Activity (Details) - $ / shares
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Equity [Abstract]      
Preferred stock authorized for issuance (in shares) 25,000,000    
Par value of preferred stock (in dollars per share) $ 1    
Shares of preferred stock outstanding (in shares) 0 0 0
Common Stock, Number of Shares, Par Value and Other Disclosures [Abstract]      
Common stock, par value (in dollars per share) $ 0.01 $ 0.01 $ 0.01
Common stock, shares authorized (in shares) 600,000,000 600,000,000 600,000,000
Changes in Total Equity [Roll Forward]      
Outstanding - beginning balance (in shares) 322,948,000 354,771,000 372,531,000
Issued for stock option exercises and other benefit plans (in shares) 3,173,000 3,375,000 4,142,000
Repurchased common stock (in shares) (27,445,000) (35,198,000) (21,902,000)
Outstanding - ending balance (in shares) 298,676,000 322,948,000 354,771,000
Treasury stock (in shares) 99,143,000 71,246,000 35,505,000
Issued (in shares) 397,819,000 394,194,000 390,276,000
v3.22.4
Common and Preferred Stock - Dividends (Details) - USD ($)
$ / shares in Units, $ in Millions
3 Months Ended 12 Months Ended
Feb. 02, 2023
Dec. 21, 2022
Sep. 22, 2022
Jun. 23, 2022
Mar. 24, 2022
Dec. 22, 2021
Sep. 23, 2021
Jun. 23, 2021
Mar. 25, 2021
Apr. 09, 2020
Dec. 31, 2022
Sep. 30, 2022
Jun. 30, 2022
Mar. 31, 2022
Dec. 31, 2021
Sep. 30, 2021
Jun. 30, 2021
Mar. 31, 2021
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Subsequent Event [Line Items]                                          
Common dividends declared (in dollars per share)                     $ 1.12 $ 1.12 $ 1.12 $ 1.12 $ 1.00 $ 1.00 $ 1.00 $ 1.00 $ 4.48 $ 4.00 $ 0.04
Amount per share (in dollars per share)   $ 1.12 $ 1.12 $ 1.12 $ 1.12 $ 1.00 $ 1.00 $ 1.00 $ 1.00 $ 0.04                      
Total amount paid   $ 334 $ 341 $ 352 $ 357 $ 324 $ 330 $ 342 $ 345 $ 15                 $ 1,384 $ 1,341 $ 15
Subsequent Event                                          
Subsequent Event [Line Items]                                          
Common dividends declared (in dollars per share) $ 1.23                                        
v3.22.4
Common and Preferred Stock - Accelerated Share Repurchase Agreements (Details) - USD ($)
$ / shares in Units, shares in Millions
1 Months Ended 3 Months Ended 5 Months Ended 6 Months Ended 12 Months Ended
Nov. 30, 2022
Jul. 31, 2022
Aug. 31, 2021
Dec. 31, 2021
Dec. 31, 2021
Dec. 31, 2022
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Jun. 30, 2022
Accelerated Share Repurchases [Line Items]                    
Accelerated stock repurchase, amount authorized     $ 2,000,000,000             $ 3,500,000,000
Accelerated stock repurchase, amount remitted   $ 3,500,000,000 $ (2,000,000,000)              
Stock repurchased (in shares) 1.9 10.4 7.7 1.8 9.5 12.3        
Stock repurchased             $ 7,593,000,000 $ 7,710,000,000 $ 4,089,000,000  
Accelerated stock repurchase, volume weighted average share price (in dollars per share)         $ 209.53 $ 285.10        
Treasury Stock                    
Accelerated Share Repurchases [Line Items]                    
Stock repurchased   $ 2,800,000,000 $ 1,600,000,000       $ 7,593,000,000 $ 7,710,000,000 $ 4,089,000,000  
v3.22.4
Insurance and Contractholder Liabilities - Account Balances (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Current        
Contractholder deposit funds $ 365 $ 352    
Future policy benefits 229      
Unearned premiums 576      
Future policy benefits, including held for sale liabilities   312    
Unearned premiums, including held for sale liabilities   558    
Total   5,929    
Insurance and contractholder liabilities classified as held for sale   (611)    
Current insurance and contractholder liabilities 5,385 5,318    
Non-current        
Contractholder deposit funds 6,515 6,702    
Future policy benefits 4,708      
Unearned premiums 22      
Future policy benefits, including held for sale liabilities   9,194    
Unearned premiums, including held for sale liabilities   418    
Total   16,596    
Insurance and contractholder liabilities classified as held for sale   (4,033)    
Non-current insurance and contractholder liabilities 11,481 12,563    
Total        
Contractholder deposit funds 6,880 7,054    
Future policy benefits 4,937      
Unearned premiums 598      
Future policy benefits, including held for sale liabilities   9,506    
Unearned premiums, including held for sale liabilities   976    
Total   22,525    
Insurance and contractholder liabilities classified as held for sale   (4,644)    
Total insurance and contractholder liabilities per Consolidated Balance Sheets 16,866 17,881    
Future policy benefits classified as liabilities of business held for sale   3,800    
Unpaid claims classified as liabilities of business held for sale   400    
Contractholder deposit funds classified as liabilities of business held for sale   400    
Cigna Healthcare        
Current        
Unpaid claims and claim expenses 4,117      
Unpaid claims and claim expenses, including held for sale liabilities   4,159    
Non-current        
Unpaid claims and claim expenses 59      
Unpaid claims and claim expenses, including held for sale liabilities   102    
Total        
Unpaid claims and claim expenses 4,176 4,261 $ 3,695 $ 3,336
Unpaid claims and claims expenses, including held for sale liabilities   4,261    
Other Operations        
Current        
Unpaid claims and claim expenses 98      
Unpaid claims and claim expenses, including held for sale liabilities   548    
Non-current        
Unpaid claims and claim expenses 177      
Unpaid claims and claim expenses, including held for sale liabilities   180    
Total        
Unpaid claims and claim expenses $ 275      
Unpaid claims and claims expenses, including held for sale liabilities   $ 728    
v3.22.4
Insurance and Contractholder Liabilities - Narrative (Details) - USD ($)
$ in Billions
Dec. 31, 2022
Dec. 31, 2021
Insurance and Contractholder Liabilities [Line Items]    
Percent of the liability for future policy benefits supported by assets held in trust 24.00%  
Minimum    
Insurance and Contractholder Liabilities [Line Items]    
Liability for future policy benefits interest rate 2.00%  
Maximum    
Insurance and Contractholder Liabilities [Line Items]    
Liability for future policy benefits interest rate 9.00%  
Cigna Healthcare    
Insurance and Contractholder Liabilities [Line Items]    
Total of incurred but not reported liabilities plus expected claim development on reported claims, including reported claims in process $ 3.9 $ 4.0
v3.22.4
Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Cigna Healthcare - Activity (Details) - Cigna Healthcare - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]      
Beginning balance $ 4,261 $ 3,695 $ 3,336
Less: Reinsurance and other amounts recoverable 261 237 318
Beginning balance, net 4,000 3,458 3,018
Incurred costs related to:      
Current year 31,342 31,755 27,494
Prior years (259) (219) (144)
Total incurred 31,083 31,536 27,350
Paid costs related to:      
Current year 27,583 27,929 24,187
Prior years 3,545 3,065 2,723
Total paid 31,128 30,994 26,910
Ending balance, net 3,955 4,000 3,458
Add: Reinsurance and other amounts recoverable 221 261 237
Ending balance $ 4,176 $ 4,261 $ 3,695
v3.22.4
Insurance and Contractholder Liabilities - Unpaid Claims and Claims Expenses - Cigna Healthcare - Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses (Details) - Cigna Healthcare - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]      
Favorable (unfavorable) variance, amount $ 259 $ 219 $ 144
Favorable (unfavorable) variance, percentage 0.80% 0.80%  
Actual completion factors      
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]      
Favorable (unfavorable) variance, amount $ 62 $ 81  
Favorable (unfavorable) variance, percentage 0.20% 0.30%  
Medical cost trend      
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]      
Favorable (unfavorable) variance, amount $ 197 $ 138  
Favorable (unfavorable) variance, percentage 0.60% 0.50%  
v3.22.4
Insurance and Contractholder Liabilities - Unpaid Claims and Claims Expenses - Cigna Healthcare - Incurred and Paid Claims Development and Unpaid Claims Liability (Details) - Cigna Healthcare
claim in Millions, $ in Millions
Dec. 31, 2022
USD ($)
claim
Dec. 31, 2021
USD ($)
Dec. 31, 2020
USD ($)
Dec. 31, 2019
USD ($)
Claims Development [Line Items]        
Incurred Costs $ 60,802      
Unpaid Claims & Claim Expenses 3,802      
Cumulative Costs Paid 57,000      
Outstanding liabilities for the periods presented, net of reinsurance 3,802      
Other long-duration liabilities not included in development table above 153      
Net unpaid claims and claims expenses - U.S. Medical 3,955 $ 4,000 $ 3,458 $ 3,018
Reinsurance and other amounts recoverable 221 261 237 318
Unpaid claims and claim expenses - U.S. Medical $ 4,176 4,261 $ 3,695 $ 3,336
Percent of health claims paid within one year 95.00%      
Incurral Year - 2021        
Claims Development [Line Items]        
Incurred Costs $ 30,493 30,735    
Unpaid Claims & Claim Expenses 180      
Cumulative Costs Paid 30,313 $ 27,039    
Outstanding liabilities for the periods presented, net of reinsurance $ 180      
Claims Frequency | claim 5      
Incurral Year - 2022        
Claims Development [Line Items]        
Incurred Costs $ 30,309      
Unpaid Claims & Claim Expenses 3,622      
Cumulative Costs Paid 26,687      
Outstanding liabilities for the periods presented, net of reinsurance $ 3,622      
Claims Frequency | claim 5      
v3.22.4
Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Other Operations - Liability Balance Details (Details) - Other Operations - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Liability for Claims and Claims Adjustment Expense [Line Items]        
Unpaid claims and claim expenses $ 275      
Unpaid claims and claim expenses, including held for sale liabilities   $ 728    
International businesses to be sold and Group Disability and Life business        
Liability for Claims and Claims Adjustment Expense [Line Items]        
Unpaid claims and claim expenses       $ 5,372
Divested International businesses        
Liability for Claims and Claims Adjustment Expense [Line Items]        
Unpaid claims and claim expenses 0   $ 452  
Unpaid claims and claim expenses, including held for sale liabilities   447    
Other Operations        
Liability for Claims and Claims Adjustment Expense [Line Items]        
Unpaid claims and claim expenses $ 275      
Unpaid claims and claim expenses, including held for sale liabilities   $ 281    
v3.22.4
Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Other Operations - Activity (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Paid costs related to:      
Short Duration Insurance Contract Discounted Liability Interest Accretion Statement Of Financial Position Extensible Enumeration Not Disclosed Flag Interest accretion    
Other Operations      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Beginning balance, including held for sale liabilities $ 728    
Paid costs related to:      
Ending balance 275    
Ending balance, including held for sale liabilities   $ 728  
Other Operations | International businesses to be sold and Group Disability and Life business      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Beginning balance     $ 5,372
Less: Reinsurance and other amounts recoverable     169
Beginning balance, net     5,203
Incurred claims related to:      
Current year     4,205
Interest accretion     154
All other incurred     48
Total incurred     4,407
Paid costs related to:      
Current year     2,392
Prior years     1,690
Total paid     4,082
Foreign currency     21
Divestiture of businesses     (5,142)
Other Operations | Divested International businesses      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Beginning balance   452  
Less: Reinsurance and other amounts recoverable   45  
Beginning balance, net   407  
Beginning balance, including held for sale liabilities 447    
Less: Reinsurance, including held for sale liabilities 46    
Beginning balance, net, including held for sale liabilities 401    
Incurred claims related to:      
Current year 507 982  
Interest accretion 0 0  
All other incurred 3 11  
Total incurred 510 993  
Paid costs related to:      
Current year 322 738  
Prior years 187 227  
Total paid 509 965  
Foreign currency (28) (34)  
Divestiture of businesses (374) 0  
Ending balance, net 0   407
Add: Reinsurance and other amounts recoverable 0   45
Ending balance 0   $ 452
Ending balance, net, including held for sale liabilities   401  
Add: Reinsurance, including held for sale liabilities   46  
Ending balance, including held for sale liabilities   447  
Other Operations | Other Operations      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Beginning balance, including held for sale liabilities 281    
Paid costs related to:      
Ending balance $ 275    
Ending balance, including held for sale liabilities   $ 281  
v3.22.4
Reinsurance - Reinsurance Recoverables (Details)
$ in Millions
Dec. 31, 2022
USD ($)
Ceded Credit Risk [Line Items]  
Reinsurance recoverables $ 4,954
Allowance for uncollectible reinsurance (37)
Total reinsurance recoverables 4,917
Other Current Assets  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 174
Fair value of collateral contractually required to meet or exceed carrying value of recoverable  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 965
Collateral provisions exist that may mitigate risk of credit loss  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 3,649
No collateral  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 340
Ongoing Operations  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 331
Ongoing Operations | A- equivalent and higher current ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 87
Ongoing Operations | BBB- to BBB+ equivalent current credit ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 58
Ongoing Operations | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 186
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 139
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | A- equivalent and higher current ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB- to BBB+ equivalent current credit ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 139
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 4
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | A- equivalent and higher current ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | BBB- to BBB+ equivalent current credit ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 4
Ongoing Operations | No collateral  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 188
Ongoing Operations | No collateral | A- equivalent and higher current ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 87
Ongoing Operations | No collateral | BBB- to BBB+ equivalent current credit ratings  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 58
Ongoing Operations | No collateral | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 43
Acquisition, disposition or run-off activities  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 4,623
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 2,795
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Berkshire Hathaway Life Insurance Company of Nebraska  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 680
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 133
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 375
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Life Insurance Company of North America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 387
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Other  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 238
Acquisition, disposition or run-off activities | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 15
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 826
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Berkshire Hathaway Life Insurance Company of Nebraska  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 248
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 375
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Life Insurance Company of North America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | BBB+ equivalent and higher current ratings | Other  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 203
Acquisition, disposition or run-off activities | Fair value of collateral contractually required to meet or exceed carrying value of recoverable | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 3,645
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 2,795
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Berkshire Hathaway Life Insurance Company of Nebraska  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 432
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Life Insurance Company of North America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 387
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Other  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 19
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 12
Acquisition, disposition or run-off activities | No collateral  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 152
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Lincoln National Life and Lincoln Life & Annuity of New York  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Berkshire Hathaway Life Insurance Company of Nebraska  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 133
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Life Insurance Company of North America  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 0
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Other  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables 16
Acquisition, disposition or run-off activities | No collateral | Not rated  
Ceded Credit Risk [Line Items]  
Reinsurance recoverables $ 3
v3.22.4
Reinsurance - Effects of Reinsurance (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Premiums      
Total premiums $ 39,915 $ 41,154 $ 42,627
Total reinsurance recoveries      
Total reinsurance recoveries 702 552 431
Short-duration contracts      
Premiums      
Direct 36,746 36,513 38,425
Assumed 416 335 85
Ceded (265) (148) (230)
Total premiums 36,897 36,700 38,280
Long-duration contracts      
Premiums      
Direct 3,219 4,753 4,517
Assumed 85 99 99
Ceded (286) (398) (269)
Total premiums $ 3,018 $ 4,454 $ 4,347
v3.22.4
Reinsurance - Effective Exit of GMDB and GMIB Business (Details) - Variable Annuity - Berkshire Hathaway Life Insurance Company of Nebraska
$ in Billions
Dec. 31, 2022
USD ($)
Effects of Reinsurance [Line Items]  
Remaining overall limit under reinsurance agreement $ 3.1
Percent of future claim payments reinsured 100.00%
v3.22.4
Reinsurance - GMDB Account Value, Net Amount at Risk and Contractholders (Details) - Variable Annuity - GMDB
contractholder in Thousands, $ in Millions
3 Months Ended 12 Months Ended
Mar. 31, 2022
contractholder
Dec. 31, 2022
USD ($)
contractholder
Dec. 31, 2021
USD ($)
Net Amount at Risk by Product and Guarantee [Line Items]      
Account value   $ 7,436 $ 9,795
Net amount at risk   $ 2,114 $ 1,392
Average attained age of contractholders (weighted by exposure)   75 years 77 years
Number of contractholders (estimated) | contractholder 170 150  
v3.22.4
Reinsurance - GMIB Reinsurers (Details) - GMIB
$ in Millions
12 Months Ended
Dec. 31, 2022
USD ($)
reinsurer
Dec. 31, 2021
USD ($)
reinsurer
Ceded Credit Risk [Line Items]    
Annuitization election period 30 days  
Impact of non-performance risk
Number of external reinsurers | reinsurer 3 3
Percent of future claim payments reinsured 100.00% 100.00%
Berkshire | Secured | GMIB Assets | Collateralization risk    
Ceded Credit Risk [Line Items]    
Concentration percentage 100.00%  
Liberty Re (Bermuda) Ltd. | Secured | GMIB Assets | Collateralization risk    
Ceded Credit Risk [Line Items]    
Concentration percentage 100.00%  
Other Contract [Member]    
Ceded Credit Risk [Line Items]    
GMIB liabilities $ 404 $ 572
GMIB recoverables 430 601
Other Contract [Member] | Berkshire    
Ceded Credit Risk [Line Items]    
GMIB recoverables 203 283
Other Contract [Member] | Sun Life Assurance Company of Canada    
Ceded Credit Risk [Line Items]    
GMIB recoverables 119 167
Other Contract [Member] | Liberty Re (Bermuda) Ltd.    
Ceded Credit Risk [Line Items]    
GMIB recoverables $ 108 $ 151
v3.22.4
Investments - Investments by Category (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Current    
Investments including held for sale assets   $ 1,264
Investments classified as assets of business held for sale   (344)
Investments per Consolidated Balance Sheets $ 905 920
Long-term    
Investments including held for sale assets   23,203
Investments classified as assets of business held for sale   (4,765)
Investments per Consolidated Balance Sheets 16,288 18,438
Total    
Investments including held for sale assets   24,467
Investments classified as assets of business held for sale   (5,109)
Investments per Consolidated Balance Sheets 17,193 19,358
Debt securities    
Current    
Investments including held for sale assets   796
Investments per Consolidated Balance Sheets 654  
Long-term    
Investments including held for sale assets   16,162
Investments per Consolidated Balance Sheets 9,218  
Total    
Investments including held for sale assets   16,958
Investments per Consolidated Balance Sheets 9,872  
Equity securities    
Current    
Investments including held for sale assets   0
Investments per Consolidated Balance Sheets 45  
Long-term    
Investments including held for sale assets   603
Investments per Consolidated Balance Sheets 577  
Total    
Investments including held for sale assets   603
Investments per Consolidated Balance Sheets 622  
Commercial mortgage loans    
Current    
Investments including held for sale assets   40
Investments per Consolidated Balance Sheets 67  
Long-term    
Investments including held for sale assets   1,526
Investments per Consolidated Balance Sheets 1,547  
Total    
Investments including held for sale assets   1,566
Investments per Consolidated Balance Sheets 1,614  
Policy loans    
Current    
Investments including held for sale assets   0
Investments per Consolidated Balance Sheets 0  
Long-term    
Investments including held for sale assets   1,338
Investments per Consolidated Balance Sheets 1,218  
Total    
Investments including held for sale assets   1,338
Investments per Consolidated Balance Sheets 1,218  
Other long-term investments    
Current    
Investments including held for sale assets   0
Investments per Consolidated Balance Sheets 0  
Long-term    
Investments including held for sale assets   3,574
Investments per Consolidated Balance Sheets 3,728  
Total    
Investments including held for sale assets   3,574
Investments per Consolidated Balance Sheets 3,728  
Short-term investments    
Current    
Investments including held for sale assets   428
Investments per Consolidated Balance Sheets 139  
Long-term    
Investments including held for sale assets   0
Investments per Consolidated Balance Sheets 0  
Total    
Investments including held for sale assets   $ 428
Investments per Consolidated Balance Sheets $ 139  
v3.22.4
Investments - Debt Securities by Contractual Maturity Periods (Details)
$ in Millions
Dec. 31, 2022
USD ($)
Amortized Cost  
Due in one year or less $ 681
Due after one year through five years 3,817
Due after five years through ten years 3,457
Due after ten years 2,497
Mortgage and other asset-backed securities 390
Total 10,842
Fair Value  
Due in one year or less 674
Due after one year through five years 3,583
Due after five years through ten years 3,052
Due after ten years 2,215
Mortgage and other asset-backed securities 348
Total $ 9,872
v3.22.4
Investments - Narrative (Details) - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Schedule of Investments [Line Items]    
Amount of impairments or value changes resulting from observable price changes on equity securities with no readily available fair value still held
Derivative gain (loss) recognized in the income statement
Derivative gain (loss) recognized in other comprehensive income
Derivative gain (loss) reclassified from other comprehensive income into shareholders' net income
v3.22.4
Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost $ 10,842  
Allowance for Credit Loss (44)  
Unrealized Appreciation 133  
Unrealized Depreciation (1,059)  
Fair Value 9,872  
Amortized cost, including held for sale assets   $ 15,775
Allowance for Credit Loss, including held for sale assets   (23)
Unrealized Appreciation, including held for sale assets   1,337
Unrealized Depreciation, including held for sale assets   (131)
Fair Value, including held for sale assets   16,958
Run-Off Settlement Annuity Business    
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets   2,262
Allowance for Credit Loss, including held for sale assets   (5)
Unrealized Appreciation, including held for sale assets   720
Unrealized Depreciation, including held for sale assets   (10)
Fair Value, including held for sale assets   2,967
Federal government and agency    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 292  
Allowance for Credit Loss 0  
Unrealized Appreciation 32  
Unrealized Depreciation (12)  
Fair Value 312  
Amortized cost, including held for sale assets   287
Allowance for Credit Loss, including held for sale assets   0
Unrealized Appreciation, including held for sale assets   101
Unrealized Depreciation, including held for sale assets   (1)
Fair Value, including held for sale assets   387
State and local government    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 43  
Allowance for Credit Loss 0  
Unrealized Appreciation 0  
Unrealized Depreciation (2)  
Fair Value 41  
Amortized cost, including held for sale assets   154
Allowance for Credit Loss, including held for sale assets   0
Unrealized Appreciation, including held for sale assets   17
Unrealized Depreciation, including held for sale assets   0
Fair Value, including held for sale assets   171
Foreign government    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 375  
Allowance for Credit Loss 0  
Unrealized Appreciation 11  
Unrealized Depreciation (21)  
Fair Value 365  
Amortized cost, including held for sale assets   2,468
Allowance for Credit Loss, including held for sale assets   0
Unrealized Appreciation, including held for sale assets   194
Unrealized Depreciation, including held for sale assets   (46)
Fair Value, including held for sale assets   2,616
Corporate    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 9,742  
Allowance for Credit Loss (44)  
Unrealized Appreciation 89  
Unrealized Depreciation (981)  
Fair Value 8,806  
Amortized cost, including held for sale assets   12,361
Allowance for Credit Loss, including held for sale assets   (23)
Unrealized Appreciation, including held for sale assets   1,008
Unrealized Depreciation, including held for sale assets   (80)
Fair Value, including held for sale assets   13,266
Mortgage and other asset-backed    
Debt Securities, Available-for-sale [Line Items]    
Amortized Cost 390  
Allowance for Credit Loss 0  
Unrealized Appreciation 1  
Unrealized Depreciation (43)  
Fair Value $ 348  
Amortized cost, including held for sale assets   505
Allowance for Credit Loss, including held for sale assets   0
Unrealized Appreciation, including held for sale assets   17
Unrealized Depreciation, including held for sale assets   (4)
Fair Value, including held for sale assets   $ 518
v3.22.4
Investments - Summary of Debt Securities with a Decline in Fair Value (Details)
$ in Millions
Dec. 31, 2022
USD ($)
position
Dec. 31, 2021
USD ($)
position
Total    
Fair Value $ 7,901  
Total Amortized Cost 8,960  
Unrealized Depreciation $ (1,059)  
Number of Issues | position 3,777  
Total Fair Value, including held for sale assets   $ 3,890
Total Amortized Cost, including held for sale assets   4,021
Total Unrealized Depreciation, including held for sale assets   $ (131)
Total Number of Issues, including held for sale assets | position   1,886
Investment grade | Debt securities    
One year or less    
Fair Value $ 5,533  
Amortized Cost 6,127  
Unrealized Depreciation $ (594)  
Number of Issues | position 1,659  
Fair Value, including held for sale assets   $ 2,785
Amortized Cost, including held for sale assets   2,861
Unrealized Depreciation, including held for sale assets   $ (76)
Number of Issues, including held for sale assets | position   909
More than one year    
Fair Value $ 1,151  
Amortized Cost 1,487  
Unrealized Depreciation $ (336)  
Number of Issues | position 462  
Fair Value, including held for sale assets   $ 382
Amortized Cost, including held for sale assets   412
Unrealized Depreciation, including held for sale assets   $ (30)
Number of Issues, including held for sale assets | position   143
Below investment grade | Debt securities    
One year or less    
Fair Value $ 887  
Amortized Cost 964  
Unrealized Depreciation $ (77)  
Number of Issues | position 1,287  
Fair Value, including held for sale assets   $ 561
Amortized Cost, including held for sale assets   578
Unrealized Depreciation, including held for sale assets   $ (17)
Number of Issues, including held for sale assets | position   781
More than one year    
Fair Value $ 330  
Amortized Cost 382  
Unrealized Depreciation $ (52)  
Number of Issues | position 369  
Fair Value, including held for sale assets   $ 162
Amortized Cost, including held for sale assets   170
Unrealized Depreciation, including held for sale assets   $ (8)
Number of Issues, including held for sale assets | position   53
v3.22.4
Investments - Equity Security Investments (Details) - USD ($)
1 Months Ended 12 Months Ended
Jan. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cost        
Equity securities with readily determinable fair values   $ 673,000,000    
Equity securities with no readily determinable fair value   380,000,000    
Total   1,053,000,000    
Equity securities with readily determinable fair values, including held for sale assets     $ 257,000,000  
Equity securities with no readily determinable fair values including held for sale assets     270,000,000  
Total, including held for sale assets     527,000,000  
Carrying Value        
Equity securities with readily determinable fair values   138,000,000    
Equity securities with no readily determinable fair value   484,000,000    
Total   622,000,000    
Equity securities with readily determinable fair values, including held for sale assets     207,000,000  
Equity securities with no readily determinable fair value, including held for sale assets     396,000,000  
Total, including held for sale assets     603,000,000  
Other Commitments [Line Items]        
Amount funded   $ 2,756,000,000 $ 3,553,000,000 $ 4,765,000,000
Equity Securities FV NI | Product Concentration Risk | Health Care Sector        
Other Commitments [Line Items]        
Concentration percentage   70.00%    
Commitment to purchase equity securities        
Other Commitments [Line Items]        
Commitment   $ 2,700,000,000    
Commitment to purchase equity securities | Subsequent Event        
Other Commitments [Line Items]        
Amount funded $ 2,500,000,000      
v3.22.4
Investments - Summary of the Credit Risk Profile of the Commercial Mortgage Loan Portfolio (Details) - Real Estate Loan - Commercial Portfolio Segment
$ in Millions
12 Months Ended
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Schedule of Investments [Line Items]    
Total $ 1,614 $ 1,566
Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio 1.89 1.96
Average Loan-to-Value Ratio 60.00% 61.00%
Below 60%    
Schedule of Investments [Line Items]    
Total $ 901 $ 560
Below 60% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio 2.12 2.18
60% to 79%    
Schedule of Investments [Line Items]    
Total $ 564 $ 883
60% to 79% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio 1.73 1.89
80% to 100%    
Schedule of Investments [Line Items]    
Total $ 149 $ 123
80% to 100% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio 1.17 1.47
v3.22.4
Investments - Carrying Values of Other Long-Term Investments (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Schedule of Investments [Line Items]      
Unfunded commitments, percentage expected to fund in next fiscal year 30.00%    
Income distributions $ 487 $ 568 $ 227
Other long-term investments 3,728    
Other long term investments, including held for sale assets   3,574  
Unfunded commitments 2,372    
Real estate investments      
Schedule of Investments [Line Items]      
Other long-term investments 1,319    
Other long term investments, including held for sale assets   1,152  
Unfunded commitments 668    
Securities partnerships      
Schedule of Investments [Line Items]      
Other long-term investments 2,166    
Other long term investments, including held for sale assets   2,272  
Unfunded commitments 1,704    
Other      
Schedule of Investments [Line Items]      
Other long-term investments 243    
Other long term investments, including held for sale assets   $ 150  
Unfunded commitments $ 0    
v3.22.4
Investments - Summary of Derivative Instruments (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Designated as Hedging Instrument | Fair Value Hedging | Foreign currency swap contracts    
Derivative [Line Items]    
Notional Value $ 1,083  
Notional Value, including held for sale assets   $ 1,081
Designated as Hedging Instrument | Fair Value Hedging | Interest rate swap contracts    
Derivative [Line Items]    
Notional Value 1,500  
Notional Value, including held for sale assets   750
Designated as Hedging Instrument | Net Investment Hedging | Foreign currency swap contracts    
Derivative [Line Items]    
Notional Value $ 460  
Notional Value, including held for sale assets   526
Designated as Hedging Instrument | Net Investment Hedging | Foreign currency forward contracts (1)    
Derivative [Line Items]    
Notional Value, including held for sale assets   1,400
Not Designated as Hedging Instrument, Economic Hedge | Foreign currency forward contracts (1)    
Derivative [Line Items]    
Notional Value, including held for sale assets   $ 700
v3.22.4
Investments - Components of Net Investment Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Net Investment Income [Line Items]      
Investment income $ 1,209 $ 1,608 $ 1,296
Less investment expenses 54 59 52
Net investment income 1,155 1,549 1,244
Debt securities      
Net Investment Income [Line Items]      
Investment income 572 689 962
Equity securities      
Net Investment Income [Line Items]      
Investment income 14 12 11
Commercial mortgage loans      
Net Investment Income [Line Items]      
Investment income 59 60 80
Policy loans      
Net Investment Income [Line Items]      
Investment income 59 63 64
Other long-term investments      
Net Investment Income [Line Items]      
Investment income 390 758 127
Short-term investments and cash      
Net Investment Income [Line Items]      
Investment income $ 115 $ 26 $ 52
v3.22.4
Investments - Realized Gains and Losses on Investments (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Investments [Abstract]      
Net realized investment (losses) gains, excluding credit loss expense and asset write-downs $ (459) $ 194 $ 186
Credit loss (expense) recoveries (36) 2 (27)
Other investment asset write-downs 0 0 (10)
Net realized investment (losses) gains, before income taxes $ (495) $ 196 $ 149
v3.22.4
Fair Value Measurements - Financial Assets and Liabilities Carried at Fair Value (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Financial assets at fair value:    
Equity securities $ 138  
Debt Securities, including held for sale assets   $ 16,958
Equity securities, including held for sale assets   207
Recurring    
Financial assets at fair value:    
Debt Securities 9,872  
Equity securities 138  
Short-term investments 139  
Debt Securities, including held for sale assets   16,958
Equity securities, including held for sale assets   207
Short-term investments, including held for sale assets   428
Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 231  
Derivative assets, including held for sale assets   143
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0  
Derivative liabilities, including held for sale liabilities   33
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities 147  
Equity securities 6  
Short-term investments 0  
Debt Securities, including held for sale assets   147
Equity securities, including held for sale assets   16
Short-term investments, including held for sale assets   0
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 0  
Derivative assets, including held for sale assets   0
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0  
Derivative liabilities, including held for sale liabilities   0
Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities 9,278  
Equity securities 132  
Short-term investments 139  
Debt Securities, including held for sale assets   16,046
Equity securities, including held for sale assets   160
Short-term investments, including held for sale assets   428
Significant Other Observable Inputs (Level 2) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 230  
Derivative assets, including held for sale assets   143
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0  
Derivative liabilities, including held for sale liabilities   33
Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities 447  
Equity securities 0  
Short-term investments 0  
Debt Securities, including held for sale assets   765
Equity securities, including held for sale assets   31
Short-term investments, including held for sale assets   0
Significant Unobservable Inputs (Level 3) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 1  
Derivative assets, including held for sale assets   0
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0  
Derivative liabilities, including held for sale liabilities   0
Federal government and agency    
Financial assets at fair value:    
Debt Securities, including held for sale assets   387
Federal government and agency | Recurring    
Financial assets at fair value:    
Debt Securities 312  
Debt Securities, including held for sale assets   387
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities 147  
Debt Securities, including held for sale assets   147
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities 165  
Debt Securities, including held for sale assets   240
Federal government and agency | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   0
State and local government    
Financial assets at fair value:    
Debt Securities, including held for sale assets   171
State and local government | Recurring    
Financial assets at fair value:    
Debt Securities 41  
Debt Securities, including held for sale assets   171
State and local government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   0
State and local government | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities 41  
Debt Securities, including held for sale assets   171
State and local government | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   0
Foreign government    
Financial assets at fair value:    
Debt Securities, including held for sale assets   2,616
Foreign government | Recurring    
Financial assets at fair value:    
Debt Securities 365  
Debt Securities, including held for sale assets   2,616
Foreign government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   0
Foreign government | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities 365  
Debt Securities, including held for sale assets   2,611
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   5
Corporate    
Financial assets at fair value:    
Debt Securities, including held for sale assets   13,266
Corporate | Recurring    
Financial assets at fair value:    
Debt Securities 8,806  
Debt Securities, including held for sale assets   13,266
Corporate | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   0
Corporate | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities 8,394  
Debt Securities, including held for sale assets   12,606
Corporate | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities 412  
Debt Securities, including held for sale assets   660
Mortgage and other asset-backed    
Financial assets at fair value:    
Debt Securities, including held for sale assets   518
Mortgage and other asset-backed | Recurring    
Financial assets at fair value:    
Debt Securities 348  
Debt Securities, including held for sale assets   518
Mortgage and other asset-backed | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities 0  
Debt Securities, including held for sale assets   0
Mortgage and other asset-backed | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities 313  
Debt Securities, including held for sale assets   418
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities $ 35  
Debt Securities, including held for sale assets   $ 100
v3.22.4
Fair Value Measurements - Narrative (Details) - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Percent of debt and equity securities classified in Level 2 94.00%  
Percent of debt and equity securities classified in Level 3 5.00%  
Separate Account Assets    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Separate accounts assets classified in Level 3, period increase (decrease), including transfers in and out of Level 3
Separate Account Assets | Recurring | Securities partnerships    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Expected liquidation period after inception 10 years  
Significant Other Observable Inputs (Level 2) | Swaps    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Adjustment for credit risk on derivatives assets $ 0  
Adjustment for credit risk on derivatives assets   0
Adjustment for credit risk on derivatives liabilities $ 0  
Adjustment for credit risk on derivatives liabilities   $ 0
v3.22.4
Fair Value Measurements - Quantitative Information About Unobservable Inputs (Details) - Recurring - Significant Unobservable Inputs (Level 3)
$ in Millions
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Debt securities    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value $ 447  
Fair Value, including held for sale assets   $ 765
Corporate and government debt securities | Securities Priced by the Company    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value $ 412  
Fair Value, including held for sale assets   $ 664
Corporate and government debt securities | Securities Priced by the Company | Minimum | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment 0.0060  
Unobservable Adjustment, including held for sale assets   0.0060
Corporate and government debt securities | Securities Priced by the Company | Maximum | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment 0.1060  
Unobservable Adjustment, including held for sale assets   0.1060
Corporate and government debt securities | Securities Priced by the Company | Weighted Average | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment 0.0265  
Unobservable Adjustment, including held for sale assets   0.0410
Mortgage and other asset-backed securities | Securities Priced by the Company    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value $ 35  
Fair Value, including held for sale assets   $ 100
Mortgage and other asset-backed securities | Securities Priced by the Company | Minimum | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment 0.0105  
Unobservable Adjustment, including held for sale assets   0.0060
Mortgage and other asset-backed securities | Securities Priced by the Company | Maximum | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment 0.0520  
Unobservable Adjustment, including held for sale assets   0.0390
Mortgage and other asset-backed securities | Securities Priced by the Company | Weighted Average | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment 0.0310  
Unobservable Adjustment, including held for sale assets   0.0100
Other debt securities    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value $ 0  
Fair Value, including held for sale assets   $ 1
v3.22.4
Fair Value Measurements - Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Transfers into/(out of) Level 3    
Change in unrealized gain or (loss) included in Other comprehensive (loss) income for assets held at the end of the reporting period $ (60) $ (10)
Debt and Equity Securities    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance   854
Beginning balance, including held for sale assets 796  
Gains (losses) included in Shareholders' net income 11 (22)
Losses included in Other comprehensive (loss) income (59) (6)
Gains (losses) required to adjust future policy benefits for settlement annuities 0 (8)
Purchases, sales and settlements    
Purchases 158 138
Sales 0 (36)
Settlements (207) (119)
Total purchases, sales and settlements (49) (17)
Transfers into/(out of) Level 3    
Transfers into Level 3 124 207
Transfers out of Level 3 (376) (212)
Total transfers into/(out of) Level 3 (252) (5)
Ending balance 447  
Ending balance, including held for sale assets   796
Total losses included in Shareholders' net income attributable to instruments held at the reporting date $ (2) $ (17)
v3.22.4
Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts $ 585  
Non-guaranteed separate accounts 5,936  
Subtotal 6,521  
Guaranteed separate accounts, including held for sale assets   $ 503
Non-guaranteed separate accounts, including held for sale assets   7,870
Subtotal, including held for sale assets   8,373
Non-guaranteed separate accounts priced at NAV as a practical expedient 757  
Non-guaranteed separate accounts priced at NAV as a practical expedient, including held for sale assets   842
Total, including held for sale assets   9,215
Separate account assets of business classified as held for sale   (878)
Separate account assets 7,278 8,337
Pension Plans    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Non-guaranteed separate accounts 4,000  
Non-guaranteed separate accounts, including held for sale assets   4,500
Quoted Prices in Active Markets for Identical Assets (Level 1)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts 203  
Non-guaranteed separate accounts 211  
Subtotal 414  
Guaranteed separate accounts, including held for sale assets   227
Non-guaranteed separate accounts, including held for sale assets   1,130
Subtotal, including held for sale assets   1,357
Significant Other Observable Inputs (Level 2)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts 382  
Non-guaranteed separate accounts 5,522  
Subtotal 5,904  
Guaranteed separate accounts, including held for sale assets   276
Non-guaranteed separate accounts, including held for sale assets   6,406
Subtotal, including held for sale assets   6,682
Significant Unobservable Inputs (Level 3)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts 0  
Non-guaranteed separate accounts 203  
Subtotal 203  
Guaranteed separate accounts, including held for sale assets   0
Non-guaranteed separate accounts, including held for sale assets   334
Subtotal, including held for sale assets   334
Significant Unobservable Inputs (Level 3) | Pension Plans    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Non-guaranteed separate accounts $ 200  
Non-guaranteed separate accounts, including held for sale assets   $ 300
v3.22.4
Fair Value Measurements - Additional Information on Separate Account Assets Priced at Net Asset Value (Details) - Separate Account Assets - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments $ 249  
Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value 757  
Fair Value, including held for sale assets   $ 842
Securities partnerships    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments 249  
Securities partnerships | Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value 451  
Fair Value, including held for sale assets   513
Real estate funds    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments $ 0  
Real estate funds | Minimum    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Redemption Notice Period 30 days  
Real estate funds | Maximum    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Redemption Notice Period 90 days  
Real estate funds | Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value $ 302  
Fair Value, including held for sale assets   325
Hedge funds    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments $ 0  
Hedge funds | Minimum    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Redemption Notice Period 30 days  
Hedge funds | Maximum    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Redemption Notice Period 90 days  
Hedge funds | Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value $ 4  
Fair Value, including held for sale assets   $ 4
v3.22.4
Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Realized investment losses on assets measured at fair value under certain conditions, after-tax
Realized investment gains on equity securities with no readily determinable fair value
v3.22.4
Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Fair Value | Significant Other Observable Inputs (Level 2)    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Long-term debt, including current maturities, excluding finance leases $ 28,653 $ 35,621
Fair Value | Significant Unobservable Inputs (Level 3)    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Commercial mortgage loans 1,491 1,598
Carrying Value    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Commercial mortgage loans 1,614 1,566
Long-term debt, including current maturities, excluding finance leases $ 30,994 $ 31,593
v3.22.4
Variable Interest Entities (Details)
$ in Millions
Dec. 31, 2022
USD ($)
entity
limitedPartnership
Dec. 31, 2021
entity
Variable Interest Entity, Primary Beneficiary    
Variable Interest Entity [Line Items]    
Number of VIEs | entity 0 0
Variable Interest Entity, Not Primary Beneficiary | Securities limited partnerships and real estate limited partnerships    
Variable Interest Entity [Line Items]    
Number of VIEs | limitedPartnership 175  
VIEs, Carrying value $ 2,700  
Maximum exposure to loss, variable interest entities 4,800  
Variable Interest Entity, Not Primary Beneficiary | Real estate joint ventures    
Variable Interest Entity [Line Items]    
Maximum exposure to loss, variable interest entities 600  
Guaranty liability 0  
Maximum guarantee exposure 340  
Variable Interest Entity, Not Primary Beneficiary | Asset-backed and corporate securities    
Variable Interest Entity [Line Items]    
Maximum exposure to loss, variable interest entities 600  
Variable Interest Entity, Not Primary Beneficiary | Other Variable Interest Entities    
Variable Interest Entity [Line Items]    
VIEs, Carrying value  
Maximum exposure to loss, variable interest entities  
Variable Interest Entity, Not Primary Beneficiary | Securities limited partnerships and real estate limited partnerships | Maximum    
Variable Interest Entity [Line Items]    
Ownership percentage, less than 10.00%  
Variable Interest Entity, Not Primary Beneficiary | Commitment to fund partnership | Securities limited partnerships and real estate limited partnerships    
Variable Interest Entity [Line Items]    
Additional commitments $ 2,100  
v3.22.4
Collectively Significant Operating Unconsolidated Subsidiaries (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Income Statement [Abstract]      
Revenues $ 180,516 $ 174,078 $ 160,401
Net income 6,746 5,415 8,489
Balance Sheet [Abstract]      
Total assets 143,932 154,889  
Total liabilities 98,981 107,705  
Operating joint ventures      
Equity Method Investment, Summarized Financial Information [Abstract]      
Equity method investments, carrying value 1,100 1,200  
Operating joint ventures      
Income Statement [Abstract]      
Revenues 4,208 3,400 2,457
Net income (15) 200 $ 401
Balance Sheet [Abstract]      
Total assets 20,676 18,942  
Total liabilities $ 18,441 $ 16,510  
v3.22.4
Accumulated Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance $ 47,130 $ 50,328 $ 45,344
Other comprehensive (loss) income, net of tax (513) (37) 72
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests (2) (14) (8)
Shareholders other comprehensive income (loss), net of tax (511) (23) 80
Balance 44,885 47,130 50,328
Accumulated Other Comprehensive (Loss)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (884) (861) (941)
Shareholders other comprehensive income (loss), net of tax (511) (23) 80
Balance (1,395) (884) (861)
Securities and Derivatives      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance 685 900 975
Other comprehensive income (loss) before reclassifications, before tax (1,528) (230) 776
Other comprehensive income (loss) before reclassifications, tax 310 31 (150)
Other comprehensive income (loss) before reclassifications, after-tax (1,218) (199) 626
Reclassification adjustment, tax (11) 5 187
Net amounts reclassified from AOCI to net income 213 (16) (701)
Shareholders other comprehensive income (loss), net of tax (1,005) (215) (75)
Balance (320) 685 900
Reclassification adjustment for losses (gains) included in Shareholders' net income (Gain on sale of businesses)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax     (862)
Net amounts reclassified from AOCI to net income 172 0  
Reclassification adjustment for losses (gains) included in Shareholders' net income (Net realized investment (losses) gains)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax 52 (21) (26)
Translation of foreign currencies attributable to parent      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (233) (15) (275)
Shareholders other comprehensive income (loss), net of tax 74 (218) 260
Balance (159) (233) (15)
Postretirement benefits liability      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (1,336) (1,746) (1,641)
Other comprehensive income (loss) before reclassifications, before tax 487 448 (206)
Other comprehensive income (loss) before reclassifications, tax (115) (106) 48
Other comprehensive income (loss) before reclassifications, after-tax 372 342 (158)
Reclassification adjustment, tax (16) (21) (17)
Net amounts reclassified from AOCI to net income 48 68 53
Shareholders other comprehensive income (loss), net of tax 420 410 (105)
Balance (916) (1,336) (1,746)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax 65 85 70
Reclassification adjustment for (gains) included in Shareholders' net income (Gain on sale of businesses)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax (1) 0 0
Reclassification adjustment for settlement (Interest expense and other)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax 0 4 0
Translation of foreign currencies attributable to noncontrolling interest      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests (2) (14) (8)
Translation of foreign currencies including portion attributable to noncontrolling interest      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Other comprehensive income (loss) including temporary equity, before reclassifications, before tax (282) (213) 232
Other comprehensive income (loss) including temporary equity, before reclassifications, tax (33) (19) 12
Other comprehensive income (loss) including temporary equity, before reclassifications, after-tax (315) (232) 244
Reclassification adjustment, before tax 358 0 11
Reclassification adjustment, tax 29 0 (3)
Net amounts reclassified from AOCI to net income 387 0 8
Other comprehensive (loss) income, net of tax $ 72 $ (232) $ 252
v3.22.4
Organizational Efficiency Plan - Narrative (Details)
$ in Millions
Dec. 31, 2022
USD ($)
Restructuring and Related Activities [Abstract]  
Restructuring Reserve $ 39
v3.22.4
Pension - Narrative (Details) - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Non-Qualified Plan      
Defined Benefit Plan Disclosure [Line Items]      
Plan assets $ 0    
Pension Plans      
Defined Benefit Plan Disclosure [Line Items]      
Market-related valuation of pension plan assets 3,800,000,000    
Plan assets 4,186,000,000 $ 4,846,000,000 $ 4,623,000,000
Contributions to qualifed pension plans 2,000,000 $ 5,000,000  
Plan assets invested in separate accounts of subsidiaries 4,000,000,000    
Plan assets invested in funds offered by an unaffiliated insurance company 200,000,000    
Pension Plans | Qualified Plan      
Defined Benefit Plan Disclosure [Line Items]      
Contributions to qualifed pension plans    
Expected contributions to qualified pension plans in next fiscal year    
v3.22.4
Pension - Projected Benefit Obligations and Assets (Details) - Pension Plans - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Change in benefit obligation      
Benefit obligation, January 1 $ 5,223 $ 5,600  
Service cost 2 2 $ 2
Interest cost 140 132 168
Actuarial (gains), net (1,094) (189)  
Benefits paid from plan assets (296) (304)  
Other (27) (18)  
Benefit obligation, December 31 3,948 5,223 5,600
Change in plan assets      
Fair value of plan assets, January 1 4,846 4,623  
Actual return on plan assets (366) 522  
Benefits paid (296) (304)  
Contributions 2 5  
Fair value of plan assets, December 31 4,186 4,846 $ 4,623
Funded status 238 (377)  
Amounts presented in Consolidated Balance Sheets      
Other assets 238 0  
Accrued expenses and other liabilities 0 (14)  
Other non-current liabilities $ 0 $ (363)  
v3.22.4
Pension - Benefit Payments (Details) - Pension Plans
$ in Millions
Dec. 31, 2022
USD ($)
Benefit payments including expected future services [Abstract]  
2023 $ 320
2024 316
2025 316
2026 316
2027 313
2028 - 2032 $ 1,508
v3.22.4
Pension - Amounts Included in Accumulated Other Comprehensive Income (Details) - Pension Plans - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Defined Benefit Plan Disclosure [Line Items]    
Unrecognized net (losses) $ (1,208) $ (1,753)
Unrecognized prior service cost (5) (5)
Postretirement benefits liability adjustment $ (1,213) $ (1,758)
v3.22.4
Pension - Net Pension Cost (Details) - Pension Plans - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Defined Benefit Plan, Net Periodic Benefit Cost (Credit) [Abstract]      
Service cost $ 2 $ 2 $ 2
Interest cost 140 132 168
Expected long-term return on plan assets (272) (269) (260)
Amortization of:      
Prior actuarial losses, net 89 78 78
Settlement loss 0 4 0
Net (benefit) cost $ (41) $ (53) $ (12)
v3.22.4
Pension - Assumptions Used for Pension (Details) - Pension Plans
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Discount rate:    
Pension benefit obligation 5.43% 2.82%
Pension benefit cost 2.82% 2.49%
Expected long-term return on plan assets:    
Pension benefit cost 6.75% 6.75%
v3.22.4
Pension - Pension Plan Assets (Details) - Pension Plans - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 4,186 $ 4,846 $ 4,623
Debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 2,947 2,501  
Target allocation percentages 80.00%    
Federal government securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 11 9  
Corporate securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 2,349 1,653  
Mortgage and other asset-backed      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 109 108  
Fund investments      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 478 731  
Other investments      
Defined Benefit Plan Disclosure [Line Items]      
Target allocation percentages 20.00%    
Equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 124 1,147  
Domestic      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 89 789  
International, including funds and pooled separate accounts      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 35 358  
Securities partnerships      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 452 514  
Real estate funds, including pooled separate accounts      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 315 334  
Commercial mortgage loans      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 63 77  
Hedge funds      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 0 0  
Guaranteed deposit account contract      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 50 91  
Cash equivalents and other current assets, net      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 235 $ 182  
v3.22.4
Pension - Annual Expense for 401(k) Plans (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Retirement Benefits [Abstract]      
Expense $ 274 $ 268 $ 243
v3.22.4
Employee Incentive Plans - Shares of Common Stock Available for Award (Details) - shares
shares in Millions
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Share-Based Payment Arrangement [Abstract]      
Common shares available for award (in shares) 16.6 19.1 20.6
v3.22.4
Employee Incentive Plans - Narrative (Details)
$ / shares in Units, shares in Thousands, $ in Millions
12 Months Ended
Dec. 31, 2022
USD ($)
employee
$ / shares
shares
Dec. 31, 2021
$ / shares
shares
Dec. 31, 2020
$ / shares
shares
Dec. 31, 2019
shares
Employee Stock Options        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Remaining maturity of traded options 1 year      
Compensation expense to be recognized $ 63      
Period over which compensation expense will be recognized 2 years      
Restricted Stock Grants and Units        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Compensation expense to be recognized $ 182      
Period over which compensation expense will be recognized 2 years      
Number of employees holding share-based payment awards | employee 10,000      
Awards outstanding (in shares) | shares 1,535 1,524 1,600 1,945
SPSs        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Compensation expense to be recognized $ 69      
Period over which compensation expense will be recognized 2 years      
Weighted average fair value per share for expense purposes, including the Monte Carlo Factor | $ / shares $ 258.37 $ 239.57 $ 206.86  
Number of employees holding share-based payment awards | employee 500      
Awards outstanding (in shares) | shares 780 860 808 818
Perfromance period 3 years      
Minimum | Employee Stock Options        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 1 year      
Minimum | Restricted Stock Grants and Units        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 1 year      
Minimum | SPSs        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Percentage of original shares granted that may be awarded at end of performance period 0.00%      
Maximum | Employee Stock Options        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 3 years      
Award expiration period 10 years      
Maximum | Restricted Stock Grants and Units        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Award vesting period 3 years      
Maximum | SPSs        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Percentage of original shares granted that may be awarded at end of performance period 200.00%      
v3.22.4
Employee Incentive Plans - Black-Scholes Option-Pricing Model Assumptions (Details) - Employee Stock Options - $ / shares
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Dividend yield 1.98% 1.85% 0.00%
Expected volatility 30.00% 30.00% 30.00%
Risk-free interest rate 1.60% 0.50% 1.40%
Expected option life 4 years 6 months 4 years 6 months 4 years 6 months
Weighted average fair value of options (in dollars per share) $ 50.61 $ 44.84 $ 52.42
v3.22.4
Employee Incentive Plans - Status of and Changes in Common Stock Options (Details) - Employee Stock Options - $ / shares
shares in Thousands
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Options      
Outstanding - January 1 (in shares) 8,490 9,742 11,438
Granted (in shares) 1,375 1,524 1,851
Exercised (in shares) (2,617) (2,584) (3,289)
Expired or canceled (in shares) (256) (192) (258)
Options outstanding - December 31 (in shares) 6,992 8,490 9,742
Options exercisable at year-end (in shares) 4,410 5,612 6,837
Weighted Average Exercise Price      
Outstanding - January 1 (in dollars per share) $ 169.47 $ 152.40 $ 136.19
Granted (in dollars per share) 226.95 213.81 191.86
Exercised (in dollars per share) 149.97 129.08 115.38
Expired or canceled (in dollars per share) 211.22 199.10 188.79
Outstanding - December 31 (in dollars per share) 186.54 169.47 152.40
Options exercisable at year-end (in dollars per share) $ 168.97 $ 152.92 $ 137.08
v3.22.4
Employee Incentive Plans - Summary of Information for Stock Options Exercised (Details) - Employee Stock Options - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Intrinsic value of options exercised $ 313 $ 268 $ 304
Cash received for options exercised 389 326 376
Tax benefit from options exercised $ 47 $ 50 $ 57
v3.22.4
Employee Incentive Plans - Summary of Information for Stock Options Outstanding (Details) - Employee Stock Options - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Options Outstanding        
Number (in shares) 6,992 8,490 9,742 11,438
Total intrinsic value $ 1,012      
Weighted average exercise price (in dollars per share) $ 186.54 $ 169.47 $ 152.40 $ 136.19
Weighted average remaining contractual life 6 years 2 months 12 days      
Options Exercisable        
Number (in shares) 4,410 5,612 6,837  
Total intrinsic value $ 716      
Weighted average exercise price (in dollars per share) $ 168.97 $ 152.92 $ 137.08  
Weighted average remaining contractual life 4 years 10 months 24 days      
v3.22.4
Employee Incentive Plans - Status of and Changes in Restricted Stock Awards and SPSs (Details) - $ / shares
shares in Thousands
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Restricted Stock Grants and Units      
Grants/Units      
Outstanding - January 1 (in shares) 1,524 1,600 1,945
Awarded (in shares) 876 899 791
Vested (in shares) (714) (866) (1,026)
Forfeited (in shares) (151) (109) (110)
Outstanding - December 31 (in shares) 1,535 1,524 1,600
Weighted Average Fair Value at Award Date      
Outstanding - January 1 (in dollars per share) $ 202.85 $ 186.12 $ 178.78
Awarded (in dollars per share) 229.60 213.82 191.22
Vested (in dollars per share) 197.83 184.07 161.58
Forfeited (in dollars per share) 215.02 197.01 186.63
Outstanding - December 31 (in dollars per share) $ 219.25 $ 202.85 $ 186.12
SPSs      
Grants/Units      
Outstanding - January 1 (in shares) 860 808 818
Awarded (in shares) 294 331 362
Vested (in shares) (261) (206) (309)
Forfeited (in shares) (113) (73) (63)
Outstanding - December 31 (in shares) 780 860 808
Weighted Average Fair Value at Award Date      
Outstanding - January 1 (in dollars per share) $ 197.07 $ 190.02 $ 177.94
Awarded (in dollars per share) 230.69 213.90 191.52
Vested (in dollars per share) 183.60 196.29 159.67
Forfeited (in dollars per share) 207.75 197.38 187.76
Outstanding - December 31 (in dollars per share) $ 212.68 $ 197.07 $ 190.02
v3.22.4
Employee Incentive Plans - Fair Value of Vested Restricted Stock and SPSs (Details) - USD ($)
shares in Thousands, $ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Restricted Stock Grants and Units      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Fair value of vested shares $ 167 $ 183 $ 190
SPSs      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Shares of The Cigna Group common stock distributed upon SPS vesting (in shares) 137 243 306
Fair value of vested shares $ 31 $ 51 $ 55
v3.22.4
Employee Incentive Plans - Compensation Cost and Tax Effects of Share-based Compensation (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Share-Based Payment Arrangement [Abstract]      
Total compensation cost for shared-based awards $ 264 $ 268 $ 289
Tax benefits recognized $ 80 $ 73 $ 63
v3.22.4
Goodwill, Other Intangibles and Property and Equipment - Narrative (Details) - USD ($)
$ in Billions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Impairments of other intangible assets
Indefinite-lived intangible assets $ 8.5 $ 8.5  
Minimum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Amortization period, other intangible assets 3 years    
Maximum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Amortization period, other intangible assets 30 years    
Buildings and Improvements | Minimum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 10 years    
Buildings and Improvements | Maximum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 40 years    
Purchased Software | Minimum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 3 years    
Purchased Software | Maximum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 5 years    
Internally-Developed Software | Minimum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 3 years    
Internally-Developed Software | Maximum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 7 years    
Furniture and Equipment (including Computer Equipment) | Minimum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 3 years    
Furniture and Equipment (including Computer Equipment) | Maximum      
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]      
Estimated useful life, property, plant and equipment 10 years    
v3.22.4
Goodwill, Other Intangibles, and Property and Equipment - Goodwill Activity (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Goodwill [Roll Forward]    
Balance at January 1 $ 45,811 $ 44,648
Goodwill acquired   1,438
Goodwill disposed (234) (10)
Impact of foreign currency translation and other adjustments 0 (31)
Balance at December 31, including held for sale assets   46,045
Balance at December 31 45,811 45,811
Goodwill classified as Assets of businesses held for sale   234
Evernorth Health Services    
Goodwill [Roll Forward]    
Balance at January 1   33,806
Goodwill acquired   1,322
Goodwill disposed 0 0
Impact of foreign currency translation and other adjustments 2 0
Balance at December 31, including held for sale assets   35,128
Balance at December 31 35,130  
Cigna Healthcare    
Goodwill [Roll Forward]    
Balance at January 1   10,577
Goodwill acquired   116
Goodwill disposed 0 (10)
Impact of foreign currency translation and other adjustments (2) 0
Balance at December 31, including held for sale assets   10,683
Balance at December 31 10,681  
Other Operations    
Goodwill [Roll Forward]    
Balance at January 1   265
Goodwill acquired   0
Goodwill disposed (234) 0
Impact of foreign currency translation and other adjustments 0 (31)
Balance at December 31, including held for sale assets   $ 234
Balance at December 31 $ 0  
v3.22.4
Goodwill, Other Intangibles, and Property and Equipment - Other Intangible Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Finite-lived intangible assets    
Accumulated Amortization $ 6,230  
Accumulated Amortization, including held for sale assets   $ 4,620
Indefinite-lived intangible assets    
Cost 8,500 8,500
Net Carrying Value 8,500 8,500
Other intangible assets    
Cost 38,722  
Net Carrying Value 32,492 34,102
Cost, including held for sale assets   38,844
Net Carrying Value, including held for sale assets   34,224
Value of business acquired ("VOBA" reported in Other assets)    
Cost 210  
Accumulated Amortization 133  
Net Carrying Value 77  
Cost, including held for sale assets   646
Accumulated Amortization, including held for sale assets   171
Net Carrying Value, including held for sale assets   475
Total (1)    
Cost 38,932  
Accumulated Amortization 6,363  
Net Carrying Value 32,569  
Cost, including held for sale assets   39,490
Accumulated Amortization, including held for sale assets   4,791
Net Carrying Value, including held for sale assets   34,699
VOBA, held for sale   386
Other intangible assets, held for sale   122
Customer relationships    
Finite-lived intangible assets    
Cost 29,974  
Accumulated Amortization 6,099  
Net Carrying Value 23,875  
Cost, including held for sale assets   29,997
Accumulated Amortization, including held for sale assets   4,539
Net Carrying Value, including held for sale assets   25,458
Trade Name - Express Scripts    
Indefinite-lived intangible assets    
Cost 8,400  
Net Carrying Value 8,400  
Cost, including held for sale assets   8,400
Net Carrying Value, including held for sale assets   8,400
Other    
Finite-lived intangible assets    
Accumulated Amortization 131  
Accumulated Amortization, including held for sale assets   81
Other intangible assets    
Cost 348  
Net Carrying Value $ 217  
Cost, including held for sale assets   447
Net Carrying Value, including held for sale assets   $ 366
v3.22.4
Goodwill, Other Intangibles, and Property and Equipment - Property and Equipment (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Property and equipment, including held for sale assets    
Cost   $ 10,708
Accumulated Amortization   6,713
Net Carrying Value   3,995
Property and equipment classified as Assets of businesses held for sale    
Cost   (424)
Accumulated Amortization   (121)
Net Carrying Value   (303)
Total Property and equipment per Consolidated Balance Sheets    
Cost $ 11,204 10,284
Accumulated amortization 7,430 6,592
Net carrying value 3,774 3,692
Internal-use software    
Property and equipment, including held for sale assets    
Cost   7,869
Accumulated Amortization   5,060
Net Carrying Value   2,809
Total Property and equipment per Consolidated Balance Sheets    
Cost 8,948  
Accumulated amortization 6,100  
Net carrying value 2,848  
Other property and equipment    
Property and equipment, including held for sale assets    
Cost   2,839
Accumulated Amortization   1,653
Net Carrying Value   $ 1,186
Total Property and equipment per Consolidated Balance Sheets    
Cost 2,256  
Accumulated amortization 1,330  
Net carrying value $ 926  
v3.22.4
Goodwill, Other Intangibles, and Property and Equipment - Components of Depreciation and Amortization Expense (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization $ 2,937 $ 2,923 $ 2,802
Internal-use software      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization 1,068 1,097 971
Other property and equipment      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization 251 253 276
Value of business acquired (reported in Other assets)      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization 12 25 28
Other intangibles      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization $ 1,606 $ 1,548 $ 1,527
v3.22.4
Goodwill, Other Intangibles, and Property and Equipment - Estimated Annual Pre-Tax Amortization for Intangible Assets (Details)
$ in Millions
Dec. 31, 2022
USD ($)
Goodwill Other Intangibles And Property And Equipment [Abstract]  
2023 $ 2,804
2024 2,302
2025 1,988
2026 1,583
2027 $ 1,523
v3.22.4
Leases - Narrative (Details)
Dec. 31, 2022
Lessee, Lease, Description [Line Items]  
Weighted average remaining lease term for operating leases 5 years
Weighted average remaining lease term for finance leases 3 years
Weighted average discount rate for operating leases 2.80%
Weighted average discount rate for finance leases 3.45%
Maximum  
Lessee, Lease, Description [Line Items]  
Term length for operating leases 35 years
v3.22.4
Leases - Components of Lease Expense (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Leases [Abstract]      
Operating lease cost $ 124 $ 170 $ 190
Finance lease cost:      
Amortization of ROU assets 33 22 28
Interest on lease liabilities 2 2 3
Total finance lease cost 35 24 31
Variable lease cost 41 39 48
Total lease cost $ 200 $ 233 $ 269
v3.22.4
Leases - Supplemental Cash Flow Information Related to Leases (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities:      
Operating cash outflows from operating leases $ 148 $ 167 $ 189
Operating cash outflows from finance leases 2 2 3
Financing cash outflows from finance leases 33 22 26
ROU assets obtained in exchange for lease obligations:      
Operating leases 43 122 189
Finance leases $ 84 $ 20 $ 9
v3.22.4
Leases - Operating and Finance Lease Right of Use ("ROU") Assets and Lease Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Operating leases:    
Operating lease ROU assets $ 375  
Accrued expenses and other liabilities 114  
Other non-current liabilities 346  
Total operating lease liabilities 460  
Operating Lease ROU assets, including held for sale assets   $ 478
Accrued expenses and other liabilities, including held for sale liabilities   159
Other non-current liabilities, including held for sale liabilities   436
Total operating lease liabilities, including held for sale liabilities   595
Finance leases:    
Property and equipment, gross 145 101
Accumulated depreciation (48) (51)
Property and equipment, net 97 50
Short-term debt 33 23
Long-term debt 66 28
Total finance lease liabilities $ 99 $ 51
Balance sheet location of operating lease ROU assets Other assets Other assets
Balance sheet location of current operating lease liabilities Accrued expenses and other liabilities Accrued expenses and other liabilities
Balance sheet location of non-current operating lease liabilities Other non-current liabilities Other non-current liabilities
Balance sheet location of non-current finance lease assets Property and equipment Property and equipment
Balance sheet location of current finance lease liabilities Short-term debt Short-term debt
Balance sheet location of non-current finance lease liabilities Long-term debt Long-term debt
Operating lease ROU assets, held for sale   $ 27
Operating lease liabilities, held for sale   $ 28
v3.22.4
Leases - Maturities of Lease Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Operating Leases    
2023 $ 114  
2024 111  
2025 84  
2026 64  
2027 47  
Thereafter 74  
Total lease payments 494  
Less: imputed interest 34  
Total 460  
Finance Leases    
2023 35  
2024 31  
2025 24  
2026 10  
2027 3  
Thereafter 2  
Total lease payments 105  
Less: imputed interest 6  
Total $ 99 $ 51
v3.22.4
Shareholders Equity and Dividend Restrictions (Details) - USD ($)
$ in Billions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Equity [Abstract]      
Net income $ 5.7 $ 3.4 $ 4.0
Surplus 16.4 $ 13.3 $ 12.9
Minimum statutory surplus required by regulators 4.2    
Investments on deposit with regulatory bodies 0.3    
Maximum dividend distributions permitted in 2023 without regulatory approval 3.2    
Maximum loans to the parent company permitted without regulatory approval 1.4    
Restricted GAAP net assets of The Cigna Group's subsidiaries 14.8    
Undistributed earnings from equity method subidiaries $ 1.2    
v3.22.4
Income Taxes - Components of Income Taxes (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Current taxes      
U.S. income taxes $ 1,679 $ 1,268 $ 2,128
Foreign income taxes 219 207 334
State income taxes 189 112 303
Total current taxes 2,087 1,587 2,765
Deferred taxes (benefits)      
U.S. income tax benefits (283) (167) (217)
Foreign income (tax benefits) taxes (28) 69 11
State income tax benefits (169) (122) (180)
Total deferred tax benefits (480) (220) (386)
Total income taxes $ 1,607 $ 1,367 $ 2,379
v3.22.4
Income Taxes - Reconciliation of Total Income Taxes to the Amount Computed Using the Nominal Federal Income Tax Rate (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
$      
Tax expense at nominal rate $ 1,754 $ 1,424 $ 2,282
Impact of sale of businesses (37) 0 104
Effect of foreign earnings (96) (33) (61)
Health insurance industry tax 0 0 93
State income tax (benefit), net of federal income tax benefit 16 (9) 24
Other (30) (15) (63)
Total income taxes $ 1,607 $ 1,367 $ 2,379
%      
Tax expense at nominal rate 21.00% 21.00% 21.00%
Impact of sale of businesses (0.40%) 0.00% 1.00%
Effect of foreign earnings (1.20%) (0.50%) (0.60%)
Health insurance industry tax 0.00% 0.00% 0.90%
State income tax (benefit), net of federal income tax benefit 0.20% (0.10%) 0.20%
Other (0.40%) (0.20%) (0.60%)
Total income taxes 19.20% 20.20% 21.90%
v3.22.4
Income Taxes - Pre-tax Income from Foreign Operations (Details)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Pre-Tax Income | Geographic Concentration Risk | Foreign      
Concentration Risk [Line Items]      
Concentration percentage 46.00% 26.00% 14.00%
v3.22.4
Income Taxes - Deferred Income Tax Assets and Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Deferred tax assets    
Employee and retiree benefit plans $ 189  
Other insurance and contractholder liabilities 311  
Loss carryforwards 205  
Other accrued liabilities 265  
Policy acquisition expenses 41  
Unrealized depreciation on investments and foreign currency translation 156  
Other 190  
Deferred tax assets before valuation allowance 1,357  
Valuation allowance for deferred tax assets (208)  
Deferred tax assets, net of valuation allowance 1,149  
Deferred tax assets, including held for sale assets    
Employee and retiree benefit plans   $ 304
Other insurance and contractholder liabilities   263
Loss carryforwards   278
Other accrued liabilities   412
Policy acquisition expenses   0
Unrealized depreciation on investments and foreign currency translation   0
Other   246
Deferred tax assets before valuation allowance   1,503
Valuation allowance for deferred tax assets   (246)
Deferred tax assets, net of valuation allowance   1,257
Deferred tax liabilities    
Depreciation and amortization 512  
Acquisition-related basis differences 8,347  
Policy acquisition expenses 0  
Unrealized appreciation on investments and foreign currency translation 0  
Other 41  
Total deferred tax liabilities 8,900  
Deferred tax liabilities, including held for sale liabilities    
Depreciation and amortization   698
Acquisition-related basis differences   8,726
Policy acquisition expenses   312
Unrealized appreciation on investments and foreign currency translation   104
Other   212
Total deferred tax liabilities   10,052
Net deferred income tax liabilities   (8,795)
Net deferred income tax liabilities classified as Liabilities of businesses held for sale   (449)
Net deferred income tax liabilities per Consolidated Balance Sheets (7,751) $ (8,346)
Deferred tax assets associated with unrealized investment losses $ 270  
v3.22.4
Income Taxes - Uncertain Tax Positions (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]      
Balance at January 1, $ 1,230 $ 1,210 $ 1,018
Increase due to prior year positions 8 21 128
Increase due to current year positions 137 31 88
Reduction related to settlements with taxing authorities (4) (15) 0
Reduction related to lapse of applicable statute of limitations (28) (17) (24)
Balance at December 31, 1,343 1,230 1,210
Liability for net interest expense on uncertain tax positions $ 176 $ 148 $ 127
v3.22.4
Contingencies and Other Matters (Details)
1 Months Ended 12 Months Ended
Mar. 31, 2022
USD ($)
Apr. 19, 2016
claim
Mar. 31, 2016
USD ($)
Dec. 31, 2022
USD ($)
Guaranty Fund Assessments        
Commitments And Contingencies [Line Items]        
Loss contingency accrual provision      
Litigation Matters and Regulatory Matters        
Commitments And Contingencies [Line Items]        
Reserves for litigation matters, pre-tax      
Express Scripts Litigation with Elevance | Judicial Ruling | Pricing Concessions        
Commitments And Contingencies [Line Items]        
Damages sought by Elevance $ 14,800,000,000      
Express Scripts Litigation with Elevance | Pending Litigation | Pricing Concessions Through Remaining Contract Term        
Commitments And Contingencies [Line Items]        
Damages sought by Elevance     $ 13,000,000,000  
Express Scripts Litigation with Elevance | Pending Litigation | Pricing Concessions After Remaining Term of Agreement        
Commitments And Contingencies [Line Items]        
Damages sought by Elevance     1,800,000,000  
Express Scripts Litigation with Elevance | Pending Litigation | Damages for Service Issues        
Commitments And Contingencies [Line Items]        
Damages sought by Elevance     $ 150,000,000  
Express Scripts counterclaims against Elevance        
Commitments And Contingencies [Line Items]        
Number of counts dismissed | claim   2    
Number of counts | claim   6    
Indemnification obligations        
Commitments And Contingencies [Line Items]        
Liability for guarantees       0
Retiree and Life Insurance Benefits | Financial Guarantees        
Commitments And Contingencies [Line Items]        
Maximum guarantee exposure       420,000,000
Assets maintained by employers (minimum)       420,000,000
Liability for guarantees       $ 0
v3.22.4
Segment Information - Summary of Special Items (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Pre-tax      
Integration and transaction-related costs, pre-tax $ 135 $ 169 $ 527
Charge for organizational efficiency plan (Selling, general and administrative expenses) 22 168  
Charge for organizational efficiency plan, 2020 (Selling, general and administrative expenses)     31
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses) (28) (27) 25
(Gain) on sale of business (1,662) 0 (4,203)
Debt extinguishment costs 0 141 199
Risk corridors recovery (Selling, general and administrative expenses) 0 0 (101)
Contractual adjustment for a former client (Pharmacy revenues) 0 0 (204)
Total impact from special items (1,533) 451 (3,726)
After-tax      
Integration and transaction-related costs, after-tax 103 71 404
Charge for organizational efficiency plan (Selling, general and administrative expenses) 17 119  
Charge for organizational efficiency plan, 2020 (Selling, general and administrative expenses)     24
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses) (20) (21) 19
(Gain) on sale of business (1,332) 0 (3,217)
Debt extinguishment costs 0 110 151
Risk corridors recovery (Selling, general and administrative expenses) 0 0 (76)
Contractual adjustment for a former client (Pharmacy revenues) 0 0 (155)
Total impact from special items $ (1,232) $ 279 $ (2,850)
v3.22.4
Segment Information - Summarized Segment Financial Information (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Segment Reporting Information [Line Items]      
Revenues from customers $ 179,361 $ 172,529 $ 159,157
Net investment income (loss) 1,155 1,549 1,244
TOTAL REVENUES 180,516 174,078 160,401
Net realized investment results from certain equity method investments 126 0 (130)
Special item related to contractual adjustment for a former client     (204)
Adjusted revenues 180,642 174,078 160,067
Depreciation and amortization 2,937 2,923 2,802
Income before income taxes 8,353 6,782 10,868
Pre-tax adjustments to reconcile to adjusted income from operations      
(Income) loss attributable to noncontrolling interests (84) (58) (37)
Net realized investment (gains) losses 621 (196) (279)
Amortization of acquired intangible assets 1,876 1,998 1,982
Special items      
Integration and transaction-related costs 135 169 527
Charge for organizational efficiency plan 22 168  
Charge for organizational efficiency plan, 2020     31
(Benefits) charges associated with litigation matters (28) (27) 25
(Gain) on sale of business (1,662) 0 (4,203)
Debt extinguishment costs 0 141 199
Risk corridors recovery 0 0 (101)
Contractual adjustment for a former client 0 0 (204)
Pre-tax adjusted income (loss) from operations 9,233 8,977 8,808
Evernorth Health Services      
Segment Reporting Information [Line Items]      
Revenues from customers 135,786 127,692 112,647
Cigna Healthcare      
Segment Reporting Information [Line Items]      
Revenues from customers 41,737 41,378 38,826
Other Operations      
Segment Reporting Information [Line Items]      
Revenues from customers 1,838 3,459 7,684
Operating Segments | Evernorth Health Services      
Segment Reporting Information [Line Items]      
Net investment income (loss) 86 17 32
TOTAL REVENUES 140,335 131,912 116,334
Net realized investment results from certain equity method investments 0 0 0
Special item related to contractual adjustment for a former client     (204)
Adjusted revenues 140,335 131,912 116,130
Depreciation and amortization 2,283 2,316 2,248
Income before income taxes 4,421 3,908 3,684
Pre-tax adjustments to reconcile to adjusted income from operations      
(Income) loss attributable to noncontrolling interests (66) (31) (17)
Net realized investment (gains) losses 0 4 (17)
Amortization of acquired intangible assets 1,772 1,937 1,917
Special items      
Integration and transaction-related costs 0 0 0
Charge for organizational efficiency plan 0 0  
Charge for organizational efficiency plan, 2020     0
(Benefits) charges associated with litigation matters 0 0 0
(Gain) on sale of business 0   0
Debt extinguishment costs   0 0
Risk corridors recovery     0
Contractual adjustment for a former client     (204)
Pre-tax adjusted income (loss) from operations 6,127 5,818 5,363
Operating Segments | Cigna Healthcare      
Segment Reporting Information [Line Items]      
Net investment income (loss) 638 1,003 473
TOTAL REVENUES 44,910 44,652 41,265
Net realized investment results from certain equity method investments 126 0 (130)
Special item related to contractual adjustment for a former client     0
Adjusted revenues 45,036 44,652 41,135
Depreciation and amortization 638 551 458
Income before income taxes 3,443 3,812 4,291
Pre-tax adjustments to reconcile to adjusted income from operations      
(Income) loss attributable to noncontrolling interests (4) (3) (1)
Net realized investment (gains) losses 530 (247) (202)
Amortization of acquired intangible assets 103 47 44
Special items      
Integration and transaction-related costs 0 0 0
Charge for organizational efficiency plan 0 0  
Charge for organizational efficiency plan, 2020     0
(Benefits) charges associated with litigation matters 0 0 0
(Gain) on sale of business 0   0
Debt extinguishment costs   0 0
Risk corridors recovery     (101)
Contractual adjustment for a former client     0
Pre-tax adjusted income (loss) from operations 4,072 3,609 4,031
Operating Segments | Other Operations      
Segment Reporting Information [Line Items]      
Net investment income (loss) 424 530 739
TOTAL REVENUES 2,262 3,989 8,446
Net realized investment results from certain equity method investments 0 0 0
Special item related to contractual adjustment for a former client     0
Adjusted revenues 2,262 3,989 8,446
Depreciation and amortization 6 52 71
Income before income taxes 2,084 852 5,227
Pre-tax adjustments to reconcile to adjusted income from operations      
(Income) loss attributable to noncontrolling interests (14) (24) (19)
Net realized investment (gains) losses 91 47 (60)
Amortization of acquired intangible assets 1 14 21
Special items      
Integration and transaction-related costs 0 0 0
Charge for organizational efficiency plan 0 0  
Charge for organizational efficiency plan, 2020     0
(Benefits) charges associated with litigation matters 0 0 0
(Gain) on sale of business (1,662)   (4,203)
Debt extinguishment costs   0 0
Risk corridors recovery     0
Contractual adjustment for a former client     0
Pre-tax adjusted income (loss) from operations 500 889 966
Corporate and Eliminations      
Segment Reporting Information [Line Items]      
Net investment income (loss) 7 (1) 0
TOTAL REVENUES (6,991) (6,475) (5,644)
Net realized investment results from certain equity method investments 0 0 0
Special item related to contractual adjustment for a former client     0
Adjusted revenues (6,991) (6,475) (5,644)
Depreciation and amortization 10 4 25
Income before income taxes (1,595) (1,790) (2,334)
Special items      
Pre-tax adjusted income (loss) from operations (1,466) (1,339) (1,552)
Corporate      
Segment Reporting Information [Line Items]      
Revenues from customers 0 0 0
Pre-tax adjustments to reconcile to adjusted income from operations      
(Income) loss attributable to noncontrolling interests 0 0 0
Net realized investment (gains) losses 0 0 0
Amortization of acquired intangible assets 0 0 0
Special items      
Integration and transaction-related costs 135 169 527
Charge for organizational efficiency plan 22 168  
Charge for organizational efficiency plan, 2020     31
(Benefits) charges associated with litigation matters (28) (27) 25
(Gain) on sale of business 0   0
Debt extinguishment costs   141 199
Risk corridors recovery     0
Contractual adjustment for a former client     0
Intersegment Eliminations      
Segment Reporting Information [Line Items]      
Revenues from customers (6,998) (6,474) (5,644)
Intersegment Eliminations | Evernorth Health Services      
Segment Reporting Information [Line Items]      
Revenues from customers (4,463) (4,203) (3,655)
Intersegment Eliminations | Cigna Healthcare      
Segment Reporting Information [Line Items]      
Revenues from customers (2,535) (2,271) (1,966)
Intersegment Eliminations | Other Operations      
Segment Reporting Information [Line Items]      
Revenues from customers $ 0 $ 0 $ (23)
v3.22.4
Segment Information - Revenue from External Customers (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Revenue from External Customer [Line Items]      
Premiums $ 39,915 $ 41,154 $ 42,627
Total revenues from external customers 179,361 172,529 159,157
Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Premiums 1 (9) (28)
Total revenues from external customers (6,998) (6,474) (5,644)
Operating Segments | Divested International businesses      
Revenue from External Customer [Line Items]      
Premiums 1,596 3,205 3,039
Operating Segments | Group Disability and Life      
Revenue from External Customer [Line Items]      
Premiums 0 0 4,423
Operating Segments | Other      
Revenue from External Customer [Line Items]      
Premiums 224 221 124
Evernorth Health Services      
Revenue from External Customer [Line Items]      
Total revenues from external customers 135,786 127,692 112,647
Evernorth Health Services | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Total revenues from external customers (4,463) (4,203) (3,655)
Cigna Healthcare      
Revenue from External Customer [Line Items]      
Total revenues from external customers 41,737 41,378 38,826
Cigna Healthcare | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Total revenues from external customers (2,535) (2,271) (1,966)
Other Operations      
Revenue from External Customer [Line Items]      
Total revenues from external customers 1,838 3,459 7,684
Other Operations | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Total revenues from external customers 0 0 (23)
Pharmacy revenues      
Revenue from External Customer [Line Items]      
Revenues 128,566 121,413 107,769
Pharmacy revenues | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Revenues (4,416) (4,398) (3,905)
Network revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 64,946 64,992 56,365
Home delivery and specialty revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 61,283 54,391 49,906
Other revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 6,753 6,428 5,403
Cigna Healthcare | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 38,094 37,737 35,069
Insured | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 15,199 14,315 13,389
Stop loss | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 5,461 4,868 4,614
Other | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 1,418 1,290 1,135
Medicare Advantage | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 7,896 8,362 7,565
Medicare Part D | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 1,224 1,499 1,593
Other | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 3,990 4,815 4,301
International Health | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 2,906 2,588 2,472
Total fees and other revenues      
Revenue from External Customer [Line Items]      
Revenues 10,880 9,962 8,761
Total fees and other revenues | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Revenues (2,583) (2,067) (1,711)
Fees | Evernorth Health Services | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 7,234 6,070 4,611
Fees | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 6,053 5,743 5,491
Fees | Other Operations | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 9 19 116
Other revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues $ 167 $ 197 $ 254
v3.22.4
Segment Information - U.S. and Foreign Revenues from External Customers (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Loss Contingencies [Line Items]      
Revenues from external customers $ 179,361 $ 172,529 $ 159,157
United States      
Loss Contingencies [Line Items]      
Revenues from external customers 174,539 166,626 154,042
Foreign countries      
Loss Contingencies [Line Items]      
Revenues from external customers 4,822 5,903 5,115
Revenues, disposal group $ 1,600 $ 3,200 $ 3,100
Revenues | Customer Concentration Risk | U.S. Federal Government Agencies      
Loss Contingencies [Line Items]      
Concentration percentage 14.00% 14.00% 15.00%
Revenues from external customers | Geographic Concentration Risk | Single foreign country      
Loss Contingencies [Line Items]      
Concentration percentage 2.00% 2.00% 2.00%
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Statements of Income (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Revenues      
Net investment income (loss) $ 1,155 $ 1,549 $ 1,244
TOTAL REVENUES 180,516 174,078 160,401
Operating expenses      
Selling, general and administrative expenses 13,186 13,030 14,072
TOTAL BENEFITS AND EXPENSES 172,102 166,143 152,248
Income from operations 8,414 7,935 8,153
Interest expense and other (1,228) (1,208) (1,438)
Debt extinguishment costs 0 (141) (199)
Net realized investment (losses) gains (495) 196 149
Income before income taxes 8,353 6,782 10,868
Income tax benefits 1,607 1,367 2,379
SHAREHOLDERS' NET INCOME 6,668 5,365 8,458
Other comprehensive income (loss), net of tax      
SHAREHOLDERS' COMPREHENSIVE INCOME 6,157 5,342 8,538
The Cigna Group      
Revenues      
Net investment income (loss) 5 0 1
Intercompany interest income 478 471 475
TOTAL REVENUES 483 471 476
Operating expenses      
Selling, general and administrative expenses 2 8 4
TOTAL BENEFITS AND EXPENSES 2 8 4
Income from operations 481 463 472
Interest expense and other (1,215) (1,197) (1,324)
Intercompany interest expense (147) (13) (48)
Debt extinguishment costs 0 (131) (171)
Income before income taxes (881) (878) (1,071)
Income tax benefits (183) (180) (234)
Loss of Parent Company (698) (698) (837)
Equity in income of subsidiaries 7,366 6,063 9,295
SHAREHOLDERS' NET INCOME 6,668 5,365 8,458
Other comprehensive income (loss), net of tax      
Net unrealized depreciation on securities and derivatives (1,005) (215) (75)
Net translation gains (losses) on foreign currencies 74 (218) 260
Postretirement benefits liability adjustment 420 410 (105)
Shareholders' other comprehensive (loss) income, net of tax (511) (23) 80
SHAREHOLDERS' COMPREHENSIVE INCOME $ 6,157 $ 5,342 $ 8,538
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Balance Sheets (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Assets      
Cash and cash equivalents $ 5,924 $ 5,081  
Other current assets 1,296 1,283  
Total current assets 30,120 36,134  
Other non-current assets 3,426 3,405  
TOTAL ASSETS 143,932 154,889  
Liabilities      
Short-term debt 2,993 2,545  
Total current liabilities 41,229 43,572  
Other non-current liabilities 3,142 3,762  
Long-term debt 28,100 31,125  
TOTAL LIABILITIES 98,981 107,705  
Shareholders' Equity      
Common stock [1] 4 4  
Additional paid-in capital 30,233 29,574  
Accumulated other comprehensive loss (1,395) (884)  
Retained earnings 37,874 32,593  
Less: Treasury stock, at cost (21,844) (14,175)  
TOTAL SHAREHOLDERS' EQUITY 44,872 47,112  
Total liabilities and equity $ 143,932 $ 154,889  
Common stock, shares issued (in shares) 397,819,000 394,194,000 390,276,000
Common stock, shares authorized (in shares) 600,000,000 600,000,000 600,000,000
The Cigna Group      
Assets      
Cash and cash equivalents $ 115 $ 33  
Short-term investments 0 99  
Other current assets 6 9  
Total current assets 121 141  
Intercompany receivable 10,366 8,962  
Investments in subsidiaries 70,877 70,896  
Other non-current assets 99 17  
TOTAL ASSETS 81,463 80,016  
Liabilities      
Short-term debt 2,749 2,453  
Other current liabilities 1,296 775  
Total current liabilities 4,045 3,228  
Intercompany payable 5,705 5  
Other non-current liabilities 26 0  
Long-term debt 26,815 29,671  
TOTAL LIABILITIES 36,591 32,904  
Shareholders' Equity      
Common stock 4 4  
Additional paid-in capital 30,233 29,574  
Accumulated other comprehensive loss (1,395) (884)  
Retained earnings 37,874 32,593  
Less: Treasury stock, at cost (21,844) (14,175)  
TOTAL SHAREHOLDERS' EQUITY 44,872 47,112  
Total liabilities and equity $ 81,463 $ 80,016  
Common stock, shares issued (in shares) 398,000,000 394,000,000  
Common stock, shares authorized (in shares) 600,000,000 600,000,000  
[1] Par value per share, $0.01; shares issued, 398 million as of December 31, 2022 and 394 million as of December 31, 2021; authorized shares, 600 million.
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Statements of Cash Flows (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 21, 2022
Sep. 22, 2022
Jun. 23, 2022
Mar. 24, 2022
Dec. 22, 2021
Sep. 23, 2021
Jun. 23, 2021
Mar. 25, 2021
Apr. 09, 2020
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cash Flows from Operating Activities                        
Shareholders' net income                   $ 6,668 $ 5,365 $ 8,458
Adjustments to reconcile shareholders' net income to net cash provided by (used in) operating activities:                        
Debt extinguishment costs                   0 141 199
Other liabilities                   1,574 (77) 1,346
Other, net                   325 333 597
NET CASH PROVIDED BY OPERATING ACTIVITIES                   8,656 7,191 10,350
Cash Flows from Investing Activities                        
Net proceeds from short-term investments sold (purchased)                   (1,563) (2,554) (1,924)
NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES                   3,098 (3,611) 2,976
Cash Flows from Financing Activities                        
Payments for debt extinguishment                   0 (136) (212)
Repayment of long-term debt                   (500) (4,578) (8,047)
Net proceeds on issuance of long-term debt                   0 4,260 3,465
Issuance of common stock                   389 326 376
Common dividends paid $ (334) $ (341) $ (352) $ (357) $ (324) $ (330) $ (342) $ (345) $ (15) (1,384) (1,341) (15)
Repurchase of common stock                   (7,607) (7,742) (4,042)
Other, net                   (23) 39 (160)
NET CASH USED IN FINANCING ACTIVITIES                   (11,240) (8,212) (8,533)
Net increase (decrease) in cash, cash equivalents and restricted cash                   428 (4,697) 4,834
Cash, cash equivalents and restricted cash and cash equivalents January 1, [1]                   5,123 10,245 [2]  
Cash, cash equivalents and restricted cash, end of year (1) [1]                   5,976 5,123 10,245 [2]
The Cigna Group                        
Cash Flows from Operating Activities                        
Shareholders' net income                   6,668 5,365 8,458
Adjustments to reconcile shareholders' net income to net cash provided by (used in) operating activities:                        
Equity in income of subsidiaries                   (7,366) (6,063) (9,295)
Debt extinguishment costs                   0 131 171
Dividends received from subsidiaries                   2,085 2,751 8,627
Other liabilities                   5 184 112
Other, net                   269 414 500
NET CASH PROVIDED BY OPERATING ACTIVITIES                   1,661 2,782 8,573
Cash Flows from Investing Activities                        
Net change in loans due from affiliates                   (901) (1,007) (265)
Net proceeds from short-term investments sold (purchased)                   99 (50) (19)
NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES                   (802) (1,057) (284)
Cash Flows from Financing Activities                        
Net change in amounts due to affiliates                   10,392 2,062 2,262
Net change in short-term debt                   (2,027) 997 86
Payments for debt extinguishment                   0 (126) (181)
Repayment of long-term debt                   (430) (4,199) (5,996)
Net proceeds on issuance of long-term debt                   0 4,260 3,465
Issuance of common stock                   389 326 376
Common dividends paid                   (1,384) (1,341) (15)
Repurchase of common stock                   (7,607) (7,742) (4,042)
Tax withholding on stock compensation and other                   (73) (86) (87)
NET CASH USED IN FINANCING ACTIVITIES                   (740) (5,849) (4,132)
Net increase (decrease) in cash, cash equivalents and restricted cash                   119 (4,124) 4,157
Cash, cash equivalents and restricted cash and cash equivalents January 1,                   33 4,157 0
Cash, cash equivalents and restricted cash, end of year (1)                   $ 152 $ 33 $ 4,157
[1] Restricted cash and cash equivalents were reported in other long-term investments.
[2] Includes $425 million reported in Assets of businesses held for sale as of January 1, 2022.
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Short-term and Credit Facilities Debt (Details)
1 Months Ended
Apr. 30, 2022
USD ($)
bank
Apr. 30, 2021
USD ($)
Dec. 31, 2022
USD ($)
Commercial Paper      
Line of Credit Facility [Line Items]      
Outstanding balances     $ 0
Maximum borrowing capacity     5,000,000,000
Revolving Credit And Letter Of Credit Facility Maturing April 2027, Revolving Credit Facility Maturing April 2025, And 364 Day Revolving Credit Agreement, Maturing April 2023      
Line of Credit Facility [Line Items]      
Outstanding balances     0
Aggregate amount of options to increase commitments $ 1,500,000,000    
Maximum total commitment $ 6,500,000,000    
Number of participating banks | bank 22    
Leverage ratio covenant 60.00%    
Revolving Credit And Letter Of Credit Facility Maturing April 2027      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 3,000,000,000    
Credit agreement term 5 years    
Credit agreement extension term 1 year    
Revolving Credit And Letter Of Credit Facility Maturing April 2027 | Letter of Credit      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 500,000,000    
Revolving Credit Facility Maturing April 2025      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 1,000,000,000    
Credit agreement term 3 years    
Credit agreement extension term 1 year    
364 Day Revolving Credit Agreement, Maturing April 2023      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 1,000,000,000    
Credit agreement term 364 days    
Credit facility, conversion to term loan, term 1 year    
Five-year Revolving Credit Agreement, Maturing April 2026      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 3,000,000,000  
Credit agreement term   5 years  
Three-year Revolving Credit Agreement, Maturing April 2024      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   3 years  
364-day Revolving Credit Agreement, Maturing April 2022      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   364 days  
The Cigna Group | Commercial Paper      
Line of Credit Facility [Line Items]      
Outstanding balances     0
Maximum borrowing capacity     5,000,000,000
The Cigna Group | Revolving Credit And Letter Of Credit Facility Maturing April 2027, Revolving Credit Facility Maturing April 2025, And 364 Day Revolving Credit Agreement, Maturing April 2023      
Line of Credit Facility [Line Items]      
Outstanding balances     $ 0
Aggregate amount of options to increase commitments $ 1,500,000,000    
Maximum total commitment $ 6,500,000,000    
Number of participating banks | bank 22    
Leverage ratio covenant 60.00%    
The Cigna Group | Revolving Credit And Letter Of Credit Facility Maturing April 2027      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 3,000,000,000    
Credit agreement term 5 years    
Credit agreement extension term 1 year    
The Cigna Group | Revolving Credit And Letter Of Credit Facility Maturing April 2027 | Letter of Credit      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 500,000,000    
The Cigna Group | Revolving Credit Facility Maturing April 2025      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 1,000,000,000    
Credit agreement term 3 years    
Credit agreement extension term 1 year    
The Cigna Group | 364 Day Revolving Credit Agreement, Maturing April 2023      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 1,000,000,000    
Credit agreement term 364 days    
Credit facility, conversion to term loan, term 1 year    
The Cigna Group | Five-year Revolving Credit Agreement, Maturing April 2026      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 3,000,000,000  
Credit agreement term   5 years  
The Cigna Group | Three-year Revolving Credit Agreement, Maturing April 2024      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   3 years  
The Cigna Group | 364-day Revolving Credit Agreement, Maturing April 2022      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   364 days  
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Debt Issuance and Redemption (Details) - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Mar. 03, 2021
Debt Instrument [Line Items]        
Aggregate principal amount of outstanding debt securities redeemed   $ 4,500,000,000    
Debt extinguishment costs $ 0 141,000,000 $ 199,000,000  
Loss on repurchase of debt, after-tax   110,000,000    
Senior Notes        
Debt Instrument [Line Items]        
Principal       $ 4,300,000,000
The Cigna Group        
Debt Instrument [Line Items]        
Aggregate principal amount of outstanding debt securities redeemed   4,200,000,000    
Debt extinguishment costs $ 0 131,000,000 $ 171,000,000  
Loss on repurchase of debt, after-tax   $ 101,000,000    
The Cigna Group | Senior Notes        
Debt Instrument [Line Items]        
Principal       $ 4,300,000,000
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Maturities of Long-Term Debt (Details)
$ in Millions
Dec. 31, 2022
USD ($)
Debt Instrument [Line Items]  
2023 $ 2,967
2024 1,500
2025 3,100
2026 2,300
2027 2,359
Maturities after 2027 19,122
The Cigna Group  
Debt Instrument [Line Items]  
2023 2,754
2024 1,214
2025 2,957
2026 2,034
2027 2,056
Maturities after 2027 $ 18,891
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Intercompany Balances (Details) - The Cigna Group - USD ($)
$ in Billions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Condensed Financial Statements, Captions [Line Items]    
Intercompany receivables, net $ 8.3 $ 7.8
Interest rate, intercompany receivables 4.65%  
Average interest rate on intercompany loan 2.82%  
v3.22.4
Schedule I - Condensed Financial Information of The Cigna Group - Guarantees (Details) - The Cigna Group
Dec. 31, 2022
USD ($)
Guarantor Obligations [Line Items]  
Maximum guarantee exposure $ 730,000,000
Liability for guarantees $ 0
v3.22.4
Schedule II - Valuation and Qualifying Accounts and Reserves (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Jan. 01, 2020
Available-for-sale debt securities        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Balance at beginning of year $ 23 $ 26 $ 0  
Charged (Credited) to costs and expenses 43 29 82  
Charged (Credited) to other accounts 0 0 0  
Other deductions (22) (32) (56)  
Balance at end of year 44 23 26  
Valuation allowance 44 23 26  
Commercial mortgage loans        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Balance at beginning of year 6 6 0  
Charged (Credited) to costs and expenses 15 0 (1)  
Charged (Credited) to other accounts 0 0 7  
Other deductions 0 0 0  
Balance at end of year 21 6 6  
Valuation allowance 21 6 6  
Commercial mortgage loans | Adjustment upon Adoption        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Valuation allowance       $ 7
Accounts receivable, net        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Balance at beginning of year 126 156 252  
Charged (Credited) to costs and expenses 99 54 (50)  
Charged (Credited) to other accounts 0 0 (12)  
Other deductions (65) (84) (34)  
Balance at end of year 160 126 156  
Valuation allowance 160 126 156  
Deferred tax asset valuation allowance        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Balance at beginning of year 246 207 196  
Charged (Credited) to costs and expenses (13) 23 10  
Charged (Credited) to other accounts (25) 16 1  
Other deductions 0 0 0  
Balance at end of year 208 246 207  
Valuation allowance 208 246 207  
Reinsurance recoverables        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Balance at beginning of year 30 32 2  
Charged (Credited) to costs and expenses 7 (2) (1)  
Charged (Credited) to other accounts 0 0 31  
Other deductions 0 0 0  
Balance at end of year 37 30 32  
Valuation allowance $ 37 $ 30 $ 32  
Reinsurance recoverables | Adjustment upon Adoption        
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]        
Valuation allowance       $ 31