CIGNA GROUP, 10-K filed on 2/29/2024
Annual Report
v3.24.0.1
Cover Page - USD ($)
$ in Billions
 12 Months Ended
Dec. 31, 2023
Jan. 31, 2024
Jun. 30, 2023
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2023    
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    
Document Financial Statement Error Correction [Flag] false    
Entity Shell Company false    
Entity Public Float     $ 82.8
Entity Common Stock, Shares Outstanding   292,355,022  
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 2024 annual meeting of shareholders.
    
Amendment Flag false    
Document Fiscal Period Focus FY    
Document Fiscal Year Focus 2023    
Entity Central Index Key 0001739940    
v3.24.0.1
Audit Information
 12 Months Ended
Dec. 31, 2023
Audit Information [Abstract]  
Auditor Name PricewaterhouseCoopers LLP
Auditor Location Hartford, Connecticut
Auditor Firm ID 238
v3.24.0.1
Consolidated Statements of Income - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
 [1]
Dec. 31, 2021
 [1]
Revenues      
Premiums $ 44,237 $ 39,916 $ 41,154
Net investment income 1,166 1,155 1,549
TOTAL REVENUES 195,265 180,518 174,069
Benefits and expenses      
Pharmacy and other service costs 133,801 124,834 117,553
Medical costs and other benefit expenses 36,287 32,184 33,565
Selling, general and administrative expenses 14,822 13,174 13,012
Amortization of acquired intangible assets 1,819 1,876 1,998
TOTAL BENEFITS AND EXPENSES 186,729 172,068 166,128
Income from operations 8,536 8,450 7,941
Interest expense and other (1,446) (1,228) (1,208)
Debt extinguishment costs 0 0 (141)
(Loss) gain on sale of businesses (1,499) 1,662 0
Net realized investment (losses) gains (78) (487) 198
Income before income taxes 5,513 8,397 6,790
TOTAL INCOME TAXES 141 1,615 1,370
Net income 5,372 6,782 5,420
Less: Net income attributable to noncontrolling interests 208 78 50
SHAREHOLDERS' NET INCOME $ 5,164 $ 6,704 $ 5,370
Shareholders' net income per share      
Basic (in dollars per share) $ 17.57 $ 21.66 $ 15.89
Diluted (in dollars per share) $ 17.39 $ 21.41 $ 15.75
Pharmacy revenues      
Revenues      
Revenues $ 137,243 $ 128,566 $ 121,413
Fees and other revenues      
Revenues      
Revenues $ 12,619 $ 10,881 $ 9,953
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Consolidated Statements of Comprehensive Income - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
 [1]
Dec. 31, 2021
 [1]
Statement of Comprehensive Income [Abstract]      
Net income $ 5,372 $ 6,782 $ 5,420
Other comprehensive income (loss), net of tax      
Net unrealized appreciation (depreciation) on securities and derivatives 503 (1,598) (302)
Net long-duration insurance and contractholder liabilities measurement adjustments (715) 509 67
Net translation gains (losses) on foreign currencies 5 77 (232)
Postretirement benefits liability adjustment 1 420 410
Other comprehensive loss, net of tax (206) (592) (57)
Total comprehensive income 5,166 6,190 5,363
Comprehensive income (loss) attributable to noncontrolling interests      
Net income attributable to redeemable noncontrolling interests 180 11 19
Net income attributable to other noncontrolling interests 28 67 31
Other comprehensive loss attributable to redeemable noncontrolling interests 0 (2) (14)
Total comprehensive income attributable to noncontrolling interests 208 76 36
SHAREHOLDERS' COMPREHENSIVE INCOME $ 4,958 $ 6,114 $ 5,327
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Consolidated Balance Sheets - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
 [1]
Assets    
Cash and cash equivalents $ 7,822 $ 5,924
Investments 925 905
Accounts receivable, net 17,722 17,218
Inventories 5,645 4,777
Other current assets 2,169 1,298
Assets of businesses held for sale 3,068 0
Total current assets 37,351 30,122
Long-term investments 17,985 16,288
Reinsurance recoverables 4,835 5,416
Property and equipment 3,695 3,774
Goodwill 44,259 45,811
Other intangible assets 30,863 32,492
Other assets 3,421 2,704
Separate account assets 7,430 7,278
Assets of businesses held for sale, non-current 2,922 0
TOTAL ASSETS 152,761 143,885
Liabilities    
Current insurance and contractholder liabilities 5,514 5,409
Pharmacy and other service costs payable 19,815 17,070
Accounts payable 8,553 7,775
Accrued expenses and other liabilities 9,955 7,978
Short-term debt 2,775 2,993
Liabilities of businesses held for sale 2,104 0
Total current liabilities 48,716 41,225
Non-current insurance and contractholder liabilities 10,904 11,976
Deferred tax liabilities, net 7,173 7,786
Other non-current liabilities 3,441 2,766
Long-term debt 28,155 28,100
Separate account liabilities 7,430 7,278
Liabilities of businesses held for sale, non-current 591 0
TOTAL LIABILITIES 106,410 99,131
Contingencies — Note 24
Redeemable noncontrolling interests 107 66
Shareholders' equity    
Common stock [2] 4 4
Additional paid-in capital 30,669 30,233
Accumulated other comprehensive loss (1,864) (1,658)
Retained earnings 41,652 37,940
Less: Treasury stock, at cost (24,238) (21,844)
TOTAL SHAREHOLDERS' EQUITY 46,223 44,675
Other noncontrolling interests 21 13
Total equity 46,244 44,688
Total liabilities and equity $ 152,761 $ 143,885
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
[2] Par value per share, $0.01; shares issued, 400 million as of December 31, 2023 and 398 million as of December 31, 2022; authorized shares, 600 million.
v3.24.0.1
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
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) 399,894,000 397,819,000 394,194,000
Common stock, shares authorized (in shares) 600,000,000 600,000,000 600,000,000
v3.24.0.1
Consolidated Statements of Changes in Total Equity - USD ($)
$ in Millions
Total
Previously Reported
Revision of Prior Period, Accounting Standards Update, Adjustment
Shareholders' Equity
Shareholders' Equity
Previously Reported
Shareholders' Equity
Revision of Prior Period, Accounting Standards Update, Adjustment
Common Stock
Common Stock
Previously Reported
Additional Paid-in Capital
Additional Paid-in Capital
Previously Reported
Accumulated Other Comprehensive (Loss)
Accumulated Other Comprehensive (Loss)
Previously Reported
Accumulated Other Comprehensive (Loss)
Revision of Prior Period, Accounting Standards Update, Adjustment
Retained Earnings
Retained Earnings
Previously Reported
Retained Earnings
Revision of Prior Period, Accounting Standards Update, Adjustment
Treasury Stock
Treasury Stock
Previously Reported
Other Non- controlling Interests
Other Non- controlling Interests
Previously Reported
Balance at Dec. 31, 2020 $ 50,189 $ 50,328 $ (139) $ 50,182 $ 50,321 $ (139) $ 4 $ 4 $ 28,975 $ 28,975 $ (1,025) $ (861) $ (164) $ 28,600 $ 28,575 $ 25 $ (6,372) $ (6,372) $ 7 $ 7
Changes in Total Equity                                        
Effect of issuing stock for employee benefit plans 511     511         604               (93)      
Other comprehensive income (loss) (43)     (43)             (43)                  
Net income 5,401     5,370                   5,370         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 46,976     46,958     4   29,574   (1,068)     32,623     (14,175)   18  
Balance at Dec. 31, 2020 58 $ 58                                    
Change in Redeemable Noncontrolling Interests                                        
Other comprehensive loss [1] (14)                                      
Net income 19                                      
Other transactions impacting noncontrolling interests (9)                                      
Balance at Dec. 31, 2021 $ 54                                      
Change in Redeemable Noncontrolling Interests                                        
Accounting Standards Update [Extensible List] Accounting Standards Update 2016-13 [Member]                                      
Effect of issuing stock for employee benefit plans $ 583     583         659               (76)      
Other comprehensive income (loss) (590)     (590)             (590)                  
Net income 6,771     6,704                   6,704         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         0                   (72)  
Balance at Dec. 31, 2022 44,688 [1]     44,675     4   30,233   (1,658)     37,940     (21,844)   13  
Change in Redeemable Noncontrolling Interests                                        
Other comprehensive loss [1] (2)                                      
Net income 11                                      
Other transactions impacting noncontrolling interests 3                                      
Balance at Dec. 31, 2022 66                                      
Changes in Total Equity                                        
Effect of issuing stock for employee benefit plans 365     365         477               (112)      
Other comprehensive income (loss) (206)     (206)             (206)                  
Net income 5,192     5,164                   5,164         28  
Common dividends declared (1,452)     (1,452)                   (1,452)            
Repurchase of common stock (2,282)     (2,282)         0               (2,282)      
Other transactions impacting noncontrolling interests (61)     (41)         (41)                   (20)  
Balance at Dec. 31, 2023 46,244     $ 46,223     $ 4   $ 30,669   $ (1,864)     $ 41,652     $ (24,238)   $ 21  
Change in Redeemable Noncontrolling Interests                                        
Other comprehensive loss 0                                      
Net income 180                                      
Other transactions impacting noncontrolling interests (139)                                      
Balance at Dec. 31, 2023 $ 107                                      
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares
 3 Months Ended 12 Months Ended
Dec. 31, 2023
Sep. 30, 2023
Jun. 30, 2023
Mar. 31, 2023
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, 2023
Dec. 31, 2022
Dec. 31, 2021
Statement of Stockholders' Equity [Abstract]                              
Common dividends declared (in dollars per share) $ 1.23 $ 1.23 $ 1.23 $ 1.23 $ 1.12 $ 1.12 $ 1.12 $ 1.12 $ 1.00 $ 1.00 $ 1.00 $ 1.00 $ 4.92 $ 4.48 $ 4.00
v3.24.0.1
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash Flows from Operating Activities      
Net income $ 5,372 $ 6,782 [1] $ 5,420 [1]
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 3,035 2,937 [1] 2,923 [1]
Realized investment losses (gains), net 78 487 [1] (198) [1]
Deferred income tax benefit (1,659) (472) [1] (216) [1]
Loss (gain) on sale of businesses 1,499 (1,662) [1] 0 [1]
Debt extinguishment costs 0 0 [1] 141 [1]
Net changes in assets and liabilities, net of non-operating effects:      
Accounts receivable, net (1,663) (2,237) [1] (2,843) [1]
Inventories (868) (1,055) [1] (557) [1]
Reinsurance recoverable and Other assets (539) 393 [1] (655) [1]
Insurance liabilities 584 (336) [1] 805 [1]
Pharmacy and other service costs payable 2,030 1,760 [1] 1,961 [1]
Accounts payable and Accrued expenses and other liabilities 3,481 1,734 [1] 77 [1]
Other, net 463 325 [1] 333 [1]
NET CASH PROVIDED BY OPERATING ACTIVITIES 11,813 8,656 [1] 7,191 [1]
Proceeds from investments sold:      
Debt securities and equity securities 1,078 1,744 [1] 2,030 [1]
Investment maturities and repayments:      
Debt securities and equity securities 972 1,327 [1] 1,628 [1]
Commercial mortgage loans 186 98 [1] 180 [1]
Other sales, maturities and repayments (primarily short-term and other long-term investments) 586 1,039 [1] 1,936 [1]
Investments purchased or originated:      
Debt securities and equity securities (4,334) (2,756) [1] (3,553) [1]
Commercial mortgage loans (118) (161) [1] (327) [1]
Other (primarily short-term and other long-term investments) (1,205) (1,563) [1] (2,554) [1]
Property and equipment purchases, net (1,573) (1,295) [1] (1,154) [1]
Acquisitions, net of cash acquired (447) 0 (1,833) [1]
Divestitures, net of cash sold 13 4,835 [1] (61) [1]
Other, net (332) (170) [1] 97 [1]
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES (5,174) 3,098 [1] (3,611) [1]
Cash Flows from Financing Activities      
Deposits and interest credited to contractholder deposit funds 167 164 [1] 153 [1]
Withdrawals and benefit payments from contractholder deposit funds (223) (220) [1] (168) [1]
Net change in short-term debt 1,198 (2,059) [1] 975 [1]
Payments for debt extinguishment 0 0 (136) [1]
Repayment of long-term debt (2,967) (500) [1] (4,578) [1]
Net proceeds on issuance of long-term debt 1,491 0 [1] 4,260 [1]
Repurchase of common stock (2,284) (7,607) [1] (7,742) [1]
Issuance of common stock 187 389 [1] 326 [1]
Common stock dividend paid (1,450) (1,384) [1] (1,341) [1]
Other, net (413) (23) [1] 39 [1]
NET CASH USED IN FINANCING ACTIVITIES (4,294) (11,240) [1] (8,212) [1]
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash 16 (86) [1] (65) [1]
Net increase (decrease) in cash, cash equivalents and restricted cash 2,361 428 [1] (4,697) [1]
Cash, cash equivalents and restricted cash January 1, including held for sale assets [1] 5,976 [2] 5,548 [2] 10,245
Cash, cash equivalents and restricted cash December 31, including held for sale assets [2] 8,337 5,976 [1] 5,548 [1]
Cash and cash equivalents reclassified to assets of businesses held for sale (467) 0 [1] (425) [1]
Cash, cash equivalents and restricted cash and cash equivalents December 31, [2] 7,870 5,976 [1] 5,123 [1]
Supplemental Disclosure of Cash Information:      
Income taxes paid, net of refunds 1,471 1,850 [1] 2,240 [1]
Interest paid $ 1,330 $ 1,229 [1] $ 1,253 [1]
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
[2] Restricted cash and cash equivalents were reported in other long-term investments.
v3.24.0.1
Description of Business
 12 Months Ended
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Description of Business
Note 1 – Description of Business
The Cigna Group, together with its subsidiaries (either individually or collectively referred to as the "Company," "we," "us" or "our"), is a global health company committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health. Powered by our people and our brands, we advance our mission to improve the health and vitality of those we serve.

Our subsidiaries offer a differentiated set of pharmacy, medical, behavioral, dental and related products and services. The majority of these products and services 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 operations, The Cigna Group also has certain run-off operations.

A full description of our segments follows:
Evernorth Health Services partners with health plans, employers, governmental organizations and health care providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions.
Cigna Healthcare includes the U.S. Healthcare and International Health operating segments which provide comprehensive medical and coordinated solutions to clients and customers. During the fourth quarter of 2023, the U.S. Commercial and U.S. Government operating segments merged to form the U.S. Healthcare operating segment. U.S. Healthcare provides commercial medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health provides health care solutions in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.
In January 2024, the Company entered into a definitive agreement to sell the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare and Other Supplemental Benefits and CareAllies businesses within the U.S. Healthcare operating segment to Health Care Service Corporation ("HCSC") for $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction").
Other Operations comprises the remainder of our business operations, which includes ongoing businesses and exited businesses. Our ongoing businesses include continuing business (corporate-owned life insurance ("COLI")), and our run-off businesses. Our run-off businesses include (i) variable annuity reinsurance business (formerly referred to as 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 which were sold through reinsurance agreements. Our exited businesses include the international life, accident and supplemental benefits businesses sold in July 2022 (the "Chubb transaction") and our interest in a joint venture in Türkiye sold in December 2022.
Corporate reflects amounts not allocated to operating segments, including net interest expense (defined as interest on corporate financing 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 eliminations for products and services sold between segments.
v3.24.0.1
Summary of Significant Accounting Policies
 12 Months Ended
Dec. 31, 2023
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 related to the adoption of Targeted Improvements for the Accounting of Long-Duration Contracts, have been reclassified to conform to the current year presentation. See "Recent Accounting Pronouncements" below.
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
Targeted Improvements to the Accounting for Long-Duration Contracts, Accounting Standards Update ("ASU") 2018-12 and related amendments

The Cigna Group adopted LDTI January 1, 2023, which includes the following key provisions:

•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) are updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.
•Discount rate assumptions are 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 are 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 ("MRB"), defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk, are measured at fair value, with changes in fair value recognized in net income each period, except for the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in other comprehensive income.
•Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, contractholder deposit funds and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.
•The transition methods applied at adoption were:
•The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings. The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.
•DAC followed the transition method used for future policyholder benefits.
•Market risk benefits were remeasured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which was recognized in accumulated other comprehensive income.
Effects of adoption:

•The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.
•The cumulative effects of adopting the new standard were immaterial. The impacts were a decrease to January 1, 2021 Shareholders' equity of $139 million and an increase to Shareholders' net income for the years ended December 31, 2022 and December 31, 2021 of $36 million and $5 million, respectively. The corresponding impact to diluted earnings per share was an increase of $0.11 and $0.02 for the years ended December 31, 2022 and December 31, 2021, respectively.
•The prior periods within our Consolidated Statements of Income, Consolidated Statements of Comprehensive Income, Consolidated Balance Sheets, Consolidated Statements of Changes in Total Equity and Consolidated Statements of Cash Flows were restated to conform to the current presentation.
•Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard. Refer to Note 10 to the Consolidated Financial Statements for the Company's updated accounting policies.
•It is possible that our income recognition pattern could change on a prospective basis for several reasons:
•Applying periodic assumption updates, versus the locked-in model, may change our timing of profit or loss recognition.
•DAC amortization is 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.

Additionally, in December 2022, the Financial Accounting Standards Board ("FASB") published ASU 2022-05, which simplified the retrospective adoption of LDTI by permitting 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.
Accounting Guidance Not Yet Adopted
There are no significant accounting pronouncements not yet adopted as of December 31, 2023.
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 80.
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.
Other Assets (Current and Non-Current)
Other current assets consist primarily of prepaid expenses, income tax receivables, accrued investment income and the current portion of reinsurance recoverables. Other assets (non-current) consist primarily of the Company's net deferred tax asset associated with foreign tax attributes (see Note 23) and the carrying value of our equity-method investments in business-related joint ventures in China, 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 15 for additional information on unconsolidated subsidiaries. Additionally, Other assets (non-current) includes operating lease right-of-use assets, various insurance-related assets and overfunded pension obligations (see Note 18). See Note 21 for the Company's accounting policy related to leases.
D.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.
E.Accrued Expenses and Other Current and Non-Current Liabilities
Accrued expenses and other liabilities (current) primarily includes financial and performance guarantee liabilities (see section G) and other liabilities arising from pharmacy contracts, management compensation, 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"), and amounts due to financial institutions under the accounts receivable factoring facility (see Note 3). Other non-current liabilities primarily include uncertain tax positions (see Note 23), amounts held for self-funded clients to cover the administration and payment of claims that may emerge post contract termination, lease liabilities (see Note 21) and underfunded pension obligations (see Note 18).
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 24.
F.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.
G.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 $1.6 billion as of December 31, 2023 and $1.3 billion as of December 31, 2022.
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.
H.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 plans 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 plans 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 individual 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. Cigna Healthcare's long-duration premium revenues are associated with contracts that provide coverage greater than one year or are guaranteed to be renewed at the option of the policyholder beyond one year. 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 10 to the Consolidated Financial Statements for further information).
I.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 solutions, 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.
v3.24.0.1
Accounts Receivable, Net
 12 Months Ended
Dec. 31, 2023
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 estimated based on the Company's best information available at the time revenue is recognized.
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, 2023December 31, 2022
Pharmaceutical manufacturers receivables$8,169 $7,108 
Noninsurance customer receivables8,044 6,899 
Insurance customer receivables2,359 2,963 
Other receivables272 248 
Total$18,844 
Accounts receivable, net classified as assets of businesses held for sale
(1,122)
Total$17,722 $17,218 
These receivables are reported net of our allowances of $3.7 billion as of December 31, 2023 and $1.9 billion as of December 31, 2022 as follows:
•Included in our Pharmaceutical manufacturers receivables are contractual allowances for certain rebates receivable with pharmaceutical manufacturers of $3.1 billion as of December 31, 2023 and $1.3 billion as of December 31, 2022.
•Included in our Noninsurance customer receivables are contractual allowances from third-party payors of $386 million as of December 31, 2023 and $336 million as of December 31, 2022 based upon the contractual payment terms.
•The remaining allowances of $219 million as of December 31, 2023 and $226 million as of December 31, 2022 include 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 $90 million as of December 31, 2023 and $86 million as of December 31, 2022.
Accounts Receivable Factoring Facility
In July 2023, the Company entered into an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution. The Facility's total capacity is $1.0 billion with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. The transactions under the Facility are accounted for as a sale and recorded as a reduction to accounts receivable in the Consolidated Balance Sheets because control of, and risk related to, the accounts receivable are transferred to the financial institution. Although the sale is made without recourse, we provide collection services related to the transferred assets. Amounts associated with this Facility are reflected within Net cash provided by operating activities in the Consolidated Statements of Cash Flows. Factoring fees paid under this Facility are reflected in Interest expense and other in the Consolidated Statements of Income.
For the year ended December 31, 2023, we sold $2.1 billion of accounts receivable under the Facility and factoring fees paid were not material. As of December 31, 2023, all sold accounts receivable have been collected from manufacturers, $515 million of which have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.
v3.24.0.1
Supplier Finance Program
 12 Months Ended
Dec. 31, 2023
Payables and Accruals [Abstract]  
Supplier Finance Program Note 4 – Supplier Finance Program
The Company facilitates a voluntary supplier finance program (the "Program") that provides suppliers the opportunity to sell their accounts receivable due from us (i.e., our payment obligations to the suppliers) to a financial institution, on a non-recourse basis, in order to be paid earlier than our payment terms require. The Cigna Group is not a party to the Program and agrees to commercial terms with its suppliers independently of their participation in the Program. Amounts due to suppliers that participate in the Program are generally paid within one month following the invoice date. A supplier's participation in the Program has no impact on the Company's payment terms and the Company has no economic interest in a supplier's decision to participate in the Program. The suppliers, at their sole discretion, determine which invoices, if any, to sell to the financial institution. No guarantees or pledged assets are provided by the Company or any of our subsidiaries under the Program.
As of December 31, 2023 and December 31, 2022, $1.5 billion and $1.3 billion, respectively, of the Company's outstanding payment obligations were confirmed as valid within the Program by the financial institution and are reflected in Accounts payable in the Consolidated Balance Sheets. The amounts confirmed as valid for both periods are predominately associated with one supplier. As of December 31, 2023, we have been informed by the financial institution that $298 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.
v3.24.0.1
Mergers, Acquisitions and Divestitures
 12 Months Ended
Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]  
Mergers, Acquisitions and Divestitures Note 5 – Mergers, Acquisitions and DivestituresInvestment in CarepathRx Health Systems Solutions
In July 2023, Evernorth Health, Inc. acquired a minority interest in CarepathRx Health Systems Solutions ("CHSS"), a provider of integrated hospital pharmacy solutions to support patients across their complete health care journey. This equity method investment is reported in Other assets and the Company's share of CHSS' net income or loss is reported in Fees and other revenues. The purchase price has been allocated to the acquired tangible and intangible assets, including customer relationships, trade names, internal-use software and goodwill. Amortization of the acquired intangibles is included in Fees and other revenues. The Company's share of CHSS' net loss and amortization of acquired intangibles were immaterial for the year ended December 31, 2023.

The Company guaranteed $125 million of CHSS' credit facilities through July 2026. The fair value of the guarantee is reflected in other liabilities and is not material. The acquisition also includes separate put and call options to increase our ownership, which
become exercisable annually beginning as early as April 2025. The net fair value of the options, determined using a Monte Carlo simulation, are not material and are included in Other non-current liabilities and Other assets, respectively.
Divestiture of International Businesses
In July 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) (the "Chubb transaction") for approximately $5.4 billion in cash and recognized a gain of $1.7 billion pre-tax ($1.4 billion after-tax), which included recognition of previously unrealized capital losses on investments sold and translation loss on foreign currencies. In 2023, we recorded immaterial adjustments to the sales price reflecting resolution of certain contractual matters. In December 2022, the Company also divested its ownership interest in a joint venture in Türkiye.
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 2023, the Company incurred net costs related to the HCSC and Chubb transactions. In 2022 and 2021, the Company incurred costs related to the Chubb transaction, the sale of the Group Disability and Life business, the acquisition of MDLIVE and the terminated merger with Elevance Health, Inc. ("Elevance"), formerly known as Anthem, Inc. These costs were $45 million pre-tax ($35 million after-tax) for the year ended December 31, 2023, compared with $135 million pre-tax ($103 million after-tax) for the year ended December 31, 2022 and $169 million pre-tax ($71 million after-tax) for the year ended December 31, 2021. 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.
v3.24.0.1
Assets and Liabilities of Businesses Held for Sale
 12 Months Ended
Dec. 31, 2023
Discontinued Operations and Disposal Groups [Abstract]  
Assets and Liabilities of Business Held for Sale
Note 6 – 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.
In January 2024, the Company entered into the HCSC transaction for a total purchase price of approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions. The transaction is expected to close in the first quarter of 2025.
During the fourth quarter of 2023, the Company determined that the Medicare Advantage, Medicare Stand-Alone Prescription Drug Plans, Medicare Supplement and CareAllies businesses met the criteria to be classified as held for sale and aggregated and classified the assets and liabilities as held for sale in our Consolidated Balance Sheet as of December 31, 2023. The Company measured the assets and liabilities held for sale at estimated fair value less costs to sell and recognized an estimated loss of $1.5 billion pre-tax ($1.4 billion after-tax) that was included within (Loss) gain on sale of businesses in the Consolidated Statements of Income for the year ended December 31, 2023. The estimated loss on sale represents primarily asset write-downs and estimated costs to sell.
The assets and liabilities of businesses held for sale were as follows:
(In millions)December 31, 2023
Cash and cash equivalents$467 
Investments1,438 
Accounts receivable, net1,122 
Other assets, including Goodwill (1)
2,963 
Total assets of businesses held for sale5,990 
Insurance and contractholder liabilities1,636 
All other liabilities1,059 
Total liabilities of businesses held for sale$2,695 
(1) Includes Goodwill of $396 million.
v3.24.0.1
Earnings Per Share
 12 Months Ended
Dec. 31, 2023
Earnings Per Share [Abstract]  
Earnings Per Share
Note 7 – 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.
Basic and diluted earnings per share were computed as follows:
For the Years Ended December 31,
202320222021
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution		DilutedBasicEffect of
Dilution		DilutedBasicEffect of
Dilution		Diluted
Shareholders' net income$5,164 $5,164 $6,704 $6,704 $5,370 $5,370 
Shares:
Weighted average293,892 293,892 309,546 309,546 337,962 337,962 
Common stock equivalents2,990 2,990 3,519 3,519 3,004 3,004 
Total shares293,892 2,990 296,882 309,546 3,519 313,065 337,962 3,004 340,966 
Earnings per share$17.57 $(0.18)$17.39 $21.66 $(0.25)$21.41 $15.89 $(0.14)$15.75 

Amounts reflected above for the years ended December 31, 2022 and 2021 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).
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)202320222021
Anti-dilutive options0.9 1.0 1.5 
v3.24.0.1
Debt
 12 Months Ended
Dec. 31, 2023
Debt Disclosure [Abstract]  
Debt
Note 8 – Debt
The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows:
(In millions)December 31, 2023December 31, 2022
Short-term debt
Commercial paper$1,237 $— 
$17 million, 8.300% Notes due January 2023
— 17 
$63 million, 7.650% Notes due March 2023
— 63 
$700 million, Floating Rate Notes due July 2023
— 700 
$1,000 million, 3.000% Notes due July 2023
— 994 
$1,187 million, 3.750% Notes due July 2023
— 1,186 
$500 million, 0.613% Notes due March 2024
500 — 
$1,000 million, 3.500% Notes due June 2024 (1)
996 — 
Other, including finance leases42 33 
Total short-term debt$2,775 $2,993 
Long-term debt
$500 million, 0.613% Notes due March 2024
$— $499 
$1,000 million, 3.500% Notes due June 2024
— 990 
$900 million, 3.250% Notes due April 2025 (2)
882 872 
$2,200 million, 4.125% Notes due November 2025 (1)
2,197 2,195 
$1,500 million, 4.500% Notes due February 2026 (1)
1,502 1,503 
$800 million, 1.250% Notes due March 2026 (1)
798 797 
$700 million, 5.685% Notes due March 2026
698 — 
$1,500 million, 3.400% Notes due March 2027
1,450 1,436 
$259 million, 7.875% Debentures due May 2027
259 259 
$600 million, 3.050% Notes due October 2027 (1)
597 597 
$3,800 million, 4.375% Notes due October 2028
3,787 3,785 
$1,500 million, 2.400% Notes due March 2030 (1)
1,493 1,492 
$1,500 million, 2.375% Notes due March 2031 (2)
1,397 1,380 
$45 million, 8.080% Step Down Notes due January 2033 (3)
45 45 
$800 million, 5.400% Notes due March 2033
794 — 
$190 million, 6.150% Notes due November 2036
190 190 
$2,200 million, 4.800% Notes due August 2038
2,193 2,192 
$750 million, 3.200% Notes due March 2040
744 743 
$121 million, 5.875% Notes due March 2041
119 119 
$448 million, 6.125% Notes due November 2041
487 488 
$317 million, 5.375% Notes due February 2042
315 315 
$1,500 million, 4.800% Notes due July 2046
1,467 1,466 
$1,000 million, 3.875% Notes due October 2047
989 989 
$3,000 million, 4.900% Notes due December 2048
2,970 2,968 
$1,250 million, 3.400% Notes due March 2050
1,237 1,236 
$1,500 million, 3.400% Notes due March 2051
1,479 1,478 
Other, including finance leases66 66 
Total long-term debt$28,155 $28,100 
(1)Included in the February 2024 debt tender offers discussed below.
(2)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 12 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments.
(3)Interest rate step down to 8.080% 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 providing liquidity support if necessary under our commercial paper program discussed below. As of December 31, 2023, there were no outstanding balances under these revolving credit agreements.
In April 2023, The Cigna Group entered into the following revolving credit agreements (the "Credit Agreements"):
•a $4.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2028 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 $4.0 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 364-day revolving credit agreement that will mature in April 2024. 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 both 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 two facilities is diversified among 21 large commercial banks, all of which had an A- equivalent or higher rating by at least one Nationally Recognized Statistical Rating Organization ("NRSRO") as of December 31, 2023. 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 in April 2027; a $1.0 billion three-year revolving credit agreement maturing in April 2025; and a $1.0 billion 364-day revolving credit agreement maturing in April 2023.
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. The weighted average interest rate of our commercial paper was 5.63% at December 31, 2023.
Long-term debt
Debt Issuance and Debt Tender Offers. On February 5, 2024, we issued $4.5 billion of new senior notes. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We intend to use the remaining net proceeds to fund the repayment of our senior notes maturing in March 2024 and for general corporate purposes, which may include repayment of indebtedness and repurchases of shares of our common stock.

Concurrent with the debt issuance, we commenced tender offers to purchase for cash up to $2.25 billion in aggregate principal amount of outstanding notes, which included any and all of the $1.0 billion senior notes due June 2024. Following the early tender results, we increased the tender offers to up to $2.55 billion aggregate principal amount. On February 22, 2024, we purchased $1.8 billion principal amount of notes at early settlement of the tender offers. The tender offers will expire on March 5, 2024.

On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance were used for general corporate purposes, and included repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

PrincipalMaturity DateInterest RateNet Proceeds
$700 million (1)
March 15, 20265.685%$698 million
$800 million (2)
March 15, 20335.400%$796 million
(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.
(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.
Debt Maturities. Maturities of outstanding long-term debt as of December 31, 2023 are as follows and exclude the impact of the 2024 debt issuance and debt tender offers described above:
(In millions)
Scheduled Maturities (1)
2024$1,500 
2025$3,100 
2026$3,000 
2027$2,359 
2028$3,800 
Maturities after 2028$16,122 
(1) Long-term debt maturity amounts include current maturities of long-term debt. Finance leases are excluded from this table. See Note 21 - Leases for finance lease maturity amounts.    
Interest Expense
Interest expense on long-term and short-term debt was $1.4 billion in 2023 and $1.3 billion in both 2022 and 2021.
Debt Covenants

The Company was in compliance with its debt covenants as of December 31, 2023.
v3.24.0.1
Common and Preferred Stock
 12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Common and Preferred Stock
Note 9 – 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, 2023, 2022 or 2021.
The following table presents the share activity of The Cigna Group:
For the Years Ended December 31,
(Shares in thousands)202320222021
Common: Par value $0.01; 600,000 shares authorized
Outstanding- January 1,298,676 322,948 354,771 
Net issued for stock option exercises and other benefit plans1,619 3,173 3,375 
Repurchased common stock(7,791)(27,445)(35,198)
Outstanding- December 31,292,504 298,676 322,948 
Treasury stock107,390 99,143 71,246 
Issued- December 31,399,894 397,819 394,194 
Dividends
During 2023, 2022 and 2021, The Cigna Group declared quarterly cash dividends of $1.23, $1.12 and $1.00 per share of the Company's common stock, respectively.
The following table provides details of the Company's dividend payments:
Record DatePayment DateAmount per Share
Total Amount Paid (in millions)
2023
March 8, 2023March 23, 2023$1.23$368
June 7, 2023June 22, 2023$1.23$362
September 6, 2023September 21, 2023$1.23$362
December 6, 2023December 21, 2023$1.23$358
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
On February 2, 2024, the Board of Directors declared the first quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on March 21, 2024 to shareholders of record on March 6, 2024. 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 February 2024, as part of our existing share repurchase program, we entered into separate accelerated share repurchase agreements ("2024 ASR agreements") with Deutsche Bank AG and Bank of America, N.A. (collectively, the "2024 Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the 2024 Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024 representing $2.6 billion of the total remitted. The final number of shares to be received under the ASR agreements will be determined based on the daily volume-weighted average share price of our common stock over the term of the agreements, less a discount and subject to adjustments pursuant to the terms and conditions of the ASR agreements. We expect final settlement under the ASR agreements to occur in the second quarter of 2024. At final settlement, we may be entitled to receive additional shares of our common stock from the Counterparties or we may be required to make a payment. If we are obligated to make a payment, we may elect to satisfy such obligation in cash or shares of our common stock.

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 of our common stock over the term of the agreements, less a discount, of $285.10 per share.
v3.24.0.1
Insurance and Contractholder Liabilities
 12 Months Ended
Dec. 31, 2023
Insurance Loss Reserves [Abstract]  
Insurance and Contractholder Liabilities 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, 2023December 31, 2022
(In millions)CurrentNon-currentTotalCurrentNon-currentTotal
Unpaid claims and claim expenses
Cigna Healthcare
$5,017 $75 $5,092 $4,117 $59 $4,176 
Other Operations99 154 253 107 177 284 
Future policy benefits
Cigna Healthcare
97 518 615 43 544 587 
Other Operations163 3,375 3,538 150 3,442 3,592 
Contractholder deposit funds
Cigna Healthcare
12 133 145 14 157 171 
Other Operations362 6,178 6,540 351 6,358 6,709 
Market risk benefits37 966 1,003 51 1,217 1,268 
Unearned premiums846 22 868 576 22 598 
Total6,633 11,421 18,054 
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)
(1,119)(517)(1,636)
Total insurance and contractholder liabilities$5,514 $10,904 $16,418 $5,409 $11,976 $17,385 
(1) Amounts classified as liabilities of businesses held for sale include $823 million of Unpaid claims, $429 million of Future policy benefits, $261 million of Unearned premiums and $123 million of Contractholder deposit funds as of December 31, 2023.

Insurance and contractholder liabilities expected to be paid within one year are classified as current. The Company adopted amended accounting guidance for long-duration insurance contracts on January 1, 2023, discussed further in Note 2 to the Consolidated Financial Statements, which resulted in restatement of prior period amounts. Additionally, see below updated accounting policies and incremental disclosures associated with future policy benefits (Note 10C), contractholder deposit funds (Note 10D), and market risk benefits (Note 10E).
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).

The Company evaluates certain insurance contracts subject to premium deficiency testing and recognizes a premium deficiency loss and corresponding reserve when expected claims costs, claims adjustment expenses, maintenance costs, and unamortized acquisition costs exceed unearned premium. Anticipated investment income is considered in the calculation of premium deficiency.
Unpaid Claims and Claim Expenses – Cigna Healthcare
This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims 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 and reported claims in process was $4.8 billion at December 31, 2023 and $3.9 billion at December 31, 2022.
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)202320222021
Beginning balance$4,176 $4,261 $3,695 
Less: Reinsurance and other amounts recoverable221 261 237 
Beginning balance, net3,955 4,000 3,458 
Incurred costs related to:
Current year35,953 31,342 31,755 
Prior years(279)(259)(219)
Total incurred35,674 31,083 31,536 
Paid costs related to:
Current year31,322 27,583 27,929 
Prior years3,451 3,545 3,065 
Total paid34,773 31,128 30,994 
Ending balance, net4,856 3,955 4,000 
Add: Reinsurance and other amounts recoverable236 221 261 
Ending balance (1)
$5,092 $4,176 $4,261 
(1) Includes $823 million classified as liabilities of businesses held for sale as of December 31, 2023.
Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 11 to the Consolidated Financial Statements for additional information on reinsurance.
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
For the Years Ended December 31,
20232022
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors$70 0.2 %$62 0.2 %
Medical cost trend209 0.7 197 0.6 
Total favorable variance$279 0.9 %$259 0.8 %
(1)Percentage of current year incurred costs as reported for the year ended December 31, 2022.
(2)Percentage of current year incurred costs as reported for the year ended December 31, 2021.

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, 2023 (net of reinsurance) reported in the Cigna Healthcare segment. The information about incurred and paid claims development for the year ended December 31, 2022 is presented as supplementary information and is unaudited.
 Incurred Costs 
Incurral Year2022
(Unaudited)		2023Unpaid Claims & Claim Expenses
(In millions)  
2022$30,309 $30,050 209 
202334,878 4,498 
Cumulative incurred costs for the periods presented$64,928  
 Cumulative Costs Paid 
Incurral Year2022
(Unaudited)		2023 
(In millions)
2022$26,687 $29,841  
202330,380  
Cumulative paid costs for the periods presented$60,221  
Outstanding liabilities for the periods presented, net of reinsurance$4,707  
Other long-duration liabilities not included in development table above149  
Net unpaid claims and claims expenses - Cigna Healthcare
4,856  
Reinsurance and other amounts recoverable236  
Unpaid claims and claim expenses - Cigna Healthcare
$5,092  
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 2023 and 2022 was approximately 5.5 million and 5.0 million, respectively.
Future Policy Benefits
Accounting Policy. Future policy benefits represent the present value of estimated future obligations, estimated using actuarial methods, for long-duration insurance policies and annuity products currently in force, consisting primarily of reserves for annuity contracts, life insurance benefits, and certain supplemental health products that are guaranteed renewable beyond one year.
Contracts are grouped at a level no higher than issue year, based on the original contract issue date, and at lower levels of disaggregation within each issue year for certain businesses to reflect factors including product type, plan type and currency. Management estimates these obligations based on assumptions for premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables, and are updated at least annually, to the extent changes in circumstances require. Interest rate assumptions are based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed income instrument"). For interest accretion purposes, interest rates are fixed at the year of the cohort's inception, however for purposes of liability measurement, are updated to the current rate quarterly, with all changes in the interest rate from inception to current period reported through Accumulated other comprehensive loss. For contracts issued domestically, we use observable inputs from a published spot rate curve for terms up to 30 years and extrapolate for longer terms using a constant forward rate approach. For contracts issued by foreign operating entities with functional currencies other than the U.S. dollar, we use observable inputs to approximate a risk free rate and add a credit spread adjustment to align with a low-credit risk fixed income instrument. For terms beyond the last observable risk free rates, which vary by international market, we extrapolate to the ultimate forward rate assuming a constant credit spread.
For the annuity business, the premium paying period is shorter than the benefit coverage period, and a deferred profit liability is reported in future policy benefits representing gross premium received in excess of net premiums. Deferred profit liability is amortized based on expected future benefit payments.
As of December 31, 2023, approximately 34% of the liability for future policy benefits, excluding amounts held for sale, was supported by assets in trust for the benefit of the ceding company under reinsurance agreements.
Cigna Healthcare

The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:
As of
December 31, 2023December 31, 2022
Interest accretion rate 2.54 %2.58 %
Current discount rate 4.92 %5.57 %
Weighted average duration 7.9 years7.7 years
The net liability for future policy benefits for the segment's supplemental health products represents the present value of benefits expected to be paid to policyholders, net of the present value of expected net premiums, which is the portion of expected future gross premium expected to be collected from policyholders that is required to provide for all expected future benefits and expenses. The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment are as follows:
For the Years Ended December 31,
(In millions)20232022
Present value of expected net premiums
Beginning balance$8,557 $9,314 
Reversal of effect of beginning of period discount rate assumptions1,537 (367)
Effect of assumption changes and actual variances from expected experience (1)
314 1,286 
Issuances and lapses 1,255 1,067 
Net premiums collected(1,370)(1,280)
Interest and other (2)
94 74 
Ending balance at original discount rate10,387 10,094 
Effect of end of period discount rate assumptions(1,154)(1,537)
Ending balance (3)
$9,233 $8,557 
Present value of expected policy benefits
Beginning balance$8,945 $9,794 
Reversal of effect of discount rate assumptions1,611 (379)
Effect of assumption changes and actual variances from expected experience (1)
112 1,148 
Issuances and lapses 1,309 1,176 
Benefit payments(1,374)(1,401)
Interest and other (2)
250 218 
Ending balance at original discount rate10,853 10,556 
Effect of discount rate assumptions(1,220)(1,611)
Ending balance (4)
$9,633 $8,945 
Liability for future policy benefits $400 $388 
Other (5)
215 199 
Total liability for future policy benefits (6)(7)
$615 $587 
(1)Includes the effect of actual variances from expectations, which (decreased)/increased the total liability for future policy benefits by $(12) million and $46 million, respectively, for the years ended December 31, 2023 and December 31, 2022.
(2)Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate.
(3)As of December 31, 2023 and December 31, 2022 undiscounted expected future gross premiums were $18.7 billion and $17.5 billion, respectively. As of December 31, 2023 and December 31, 2022 discounted expected future gross premiums were $13.5 billion and $12.2 billion, respectively.
(4)As of December 31, 2023 and December 31, 2022, undiscounted expected future policy benefits were $13.3 billion and $12.7 billion, respectively.
(5)The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.
(6)$72 million and $155 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of December 31, 2023 and December 31, 2022, respectively, relate to the liability for future policy benefits. Additionally, $79 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of December 31, 2023.
(7)Includes $429 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of December 31, 2023.
Other Operations
The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows:
As of
December 31, 2023December 31, 2022
Interest accretion rate 5.64 %5.64 %
Current discount rate 4.87 %5.19 %
Weighted average duration 11.4 years11.5 years

Obligations for annuities represent discounted periodic benefits to be paid to an individual or groups of individuals over their remaining lives. Other Operations' traditional insurance contracts, which are in run-off, have no premium remaining to be collected;
therefore, future policy benefit reserves represent the present value of expected future policy benefits, discounted using the current discount rate, and the remaining amortizable deferred profit liability.
Future policy benefits for Other Operations includes deferred profit liability of $384 million and $390 million as of December 31, 2023 and December 31, 2022, respectively. Future policy benefits excluding deferred profit liability were $3.2 billion as of both December 31, 2023 and December 31, 2022, and $4.3 billion as of December 31, 2021. These balances exclude amounts classified as liabilities of businesses held for sale of $3.8 billion as of December 31, 2021. The change in future policy benefits reserves year-to-date was primarily driven by changes in the current discount rate.

Undiscounted expected future policy benefits were $4.5 billion as of December 31, 2023 and $4.6 billion as of December 31, 2022. As of December 31, 2023 and December 31, 2022, $1.0 billion and $1.1 billion, respectively, of the future policy benefit reserve was recoverable through treaties with external reinsurers.
Contractholder Deposit Funds
Accounting Policy. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products as well as investment earnings on their fund balances in Other Operations. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. Interest credited on these funds is accrued ratably over the contract period.
Contractholder deposit fund liabilities within Other Operations were $6.5 billion, $6.7 billion and $6.9 billion as of December 31, 2023, December 31, 2022 and December 31, 2021, respectively. Approximately 39% of the balance is reinsured externally as of both December 31, 2023 and December 31, 2022. Activity in these liabilities is presented net of reinsurance in the Consolidated Statements of Cash Flows. The net year-to-date decrease in contractholder deposit fund liabilities generally relates to withdrawals and benefit payments from contractholder deposit funds, partially offset by deposits and interest credited to contractholder deposit funds.
As of December 31, 2023, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.31%, $3.0 billion and $2.8 billion, respectively. The comparative amounts as of December 31, 2022 were 3.08%, $3.0 billion and $2.4 billion, respectively. More than 99% of the $4.0 billion liability as of December 31, 2023 and the $4.1 billion liability as of December 31, 2022 not reinsured externally is for contracts with guaranteed interest rates of 3% - 4%, and approximately $1.2 billion represented contracts with policies at the guarantee. At both of these same period ends, $1.2 billion was 50-150 basis points ("bps") above the guarantee and the remaining $1.6 billion as of December 31, 2023 and $1.7 billion as of December 31, 2022 represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value. More than 90% of these contracts have actual cash values of at least 110% of the guaranteed cash value.
Market Risk Benefits
Liabilities for market risk benefits consist of variable annuity reinsurance contracts (formerly referred to as GMDB and GMIB contracts) in Other Operations. These liabilities arise under annuities and riders to annuities written by ceding companies that guarantee the benefit received at death and, for a subset of policies, also provide contractholders the option, within 30 days of a policy anniversary after the appropriate waiting period, to elect minimum income payments. The Company's capital market risk exposure on variable annuity reinsurance contracts arises when the reinsured guaranteed minimum benefit exceeds the contractholder's account value in the related underlying mutual funds at the time the insurance benefit is payable under the respective contract. The Company receives and pays premium periodically based on the terms of the reinsurance agreements.
Accounting Policy. Variable annuity reinsurance liabilities are measured as MRBs at fair value, net of nonperformance risk, with fluctuations in value gross of reinsurer nonperformance risk reported in benefit expenses, while fluctuations in the Company's own nonperformance risk (own credit risk) are reported in Accumulated other comprehensive loss. Nonperformance risk reflects risk that a party might default and therefore not fulfill its obligations (i.e. nonpayment risk). The nonperformance 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 variable annuity reinsurance liabilities to be paid by the Company and (b) the variable annuity reinsurance assets to be paid by the reinsurers, after considering collateral. The Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy described in Note 13 to the Consolidated Financial Statements because assumptions related to future annuitant behavior are largely unobservable. As discussed further in Note 11 to the Consolidated Financial Statements, due to the reinsurance agreements covering these liabilities, the liabilities do not generally impact net income except for the change in nonperformance risk on the reinsurance recoverable, which is reported in benefit expenses and does not offset the nonperformance risk valuation on the liability. Variable annuity liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates).
Market risk benefits activity was as follows:
For the Years Ended December 31,
(Dollars in millions)20232022
Balance, beginning of year$1,268 $1,824 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,379 1,949 
Changes due to expected run-off(19)(54)
Changes due to capital markets versus expected(254)(567)
Changes due to policyholder behavior versus expected(5)(14)
Assumption changes(16)65 
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)1,085 1,379 
Nonperformance risk (own credit risk), end of period(82)(111)
Balance, end of period$1,003 $1,268 
Reinsured market risk benefit, end of period$1,081 $1,374 
The following table presents the account value, net amount at risk, average attained age of contractholders (weighted by exposure) and the number of contractholders for guarantees assumed by the Company. The net amount at risk is the amount that the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. As of December 31, 2023, the account value increased primarily due to favorable equity market performance, which resulted in an decrease 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, 2023December 31, 2022
Account value$7,736 $7,436 
Net amount at risk$1,609 $2,494 
Average attained age of contractholders (weighted by exposure)77.3 years74.7 years
Number of contractholders (estimated)140,000 150,000 
v3.24.0.1
Reinsurance
 12 Months Ended
Dec. 31, 2023
Reinsurance Disclosures [Abstract]  
Reinsurance
Note 11 – 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 Recoverables
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 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, 2023 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:
(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 (2)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (1)
$— $— $90 $90 
BBB- to BBB+ equivalent current credit ratings (1)
— — 59 59 
Not rated151 5 182 338 
Total recoverables related to ongoing operations151 5 331 487 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York— 2,656 — 2,656 
Empower Annuity Insurance Company— — 130 130 
Prudential Insurance Company of America341 — — 341 
Life Insurance Company of North America— 356 — 356 
Other166 19 14 199 
Not rated— 7 4 11 
Total recoverables related to acquisition, disposition or run-off activities507 3,038 148 3,693 
Total reinsurance recoverables before market risk benefits$658 $3,043 $479 $4,180 
Allowance for uncollectible reinsurance(35)
Market risk benefits (3)
1,081 
Total reinsurance recoverables (4)
$5,226 
(1)Certified by a NRSRO.
(2)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
(3)Prior to the adoption of LDTI, "acquisition, disposition or run-off activities" in the table above included Berkshire and certain Other recoverables that are related to the Company's variable annuity reinsurance products discussed in section B below. These amounts are now reported at fair market value as MRBs, as further discussed in Note 10 to the Consolidated Financial Statements. At December 31, 2022, we reported $711 million of recoverables related to the GMDB variable annuity reinsurance product. The restated December 31, 2022 variable annuity reinsurance recoverable balance is $1.4 billion, which also includes the GMIB variable annuity reinsurance product that was classified in Other assets prior to the adoption of LDTI.
(4)Includes $183 million of current reinsurance recoverables that are reported in Other current assets and $208 million of reinsurance recoverables classified as assets of businesses held for sale.

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.
Effective Exit of Variable Annuity Reinsurance Business
The Company entered into an agreement with Berkshire to effectively exit the variable annuity reinsurance business via a reinsurance transaction in 2013. Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 10 to the Consolidated Financial Statements. Berkshire reinsured 100% of the Company's future cash flows 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, 2023. As a result of the reinsurance transaction, amounts payable are offset by a corresponding reinsurance recoverable, provided the increased recoverable remains within the overall Berkshire limit.
(In millions)
Reinsurer (1)
December 31, 2023December 31, 2022
Collateral and Other Terms
at December 31, 2023
Berkshire$873 $1,116 
95% were secured by assets in a trust.
Sun Life Assurance Company of Canada92 115 
Liberty Re (Bermuda) Ltd.104 128 
100% were secured by assets in a trust.
SCOR SE31 39 
80% were secured by a letter of credit.
Market risk benefits (2)
$1,100 $1,398 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes IBNR and outstanding claims of $19 million. These amounts are excluded from market risk benefits at December 31, 2023 in Note 10 and Note 11A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.

The impact of nonperformance risk (i.e., the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the years ended 2023, 2022 and 2021.
Effects of Reinsurance
The following table presents direct, assumed and ceded earned 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)202320222021
Premiums
Short-duration contracts
Direct$42,266 $36,747 $36,513 
Assumed303 416 335 
Ceded(277)(265)(148)
Total short-duration contract premiums(1)
42,292 36,898 36,700 
Long-duration contracts
Direct2,084 3,219 4,753 
Assumed72 85 99 
Ceded(211)(286)(398)
Total long-duration contract premiums1,945 3,018 4,454 
Total premiums$44,237 $39,916 $41,154 
Total reinsurance recoveries$456 $702 $552 
(1) Total short-duration contracts written premiums were $41.1 billion, $35.0 billion and $35.6 billion for 2023, 2022 and 2021, respectively.
v3.24.0.1
Investments
 12 Months Ended
Dec. 31, 2023
Investments [Abstract]  
Investments
Note 12 – 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 13 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, 2023December 31, 2022
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$590 $9,265 $9,855 $654 $9,218 $9,872 
Equity securities31 3,331 3,362 45 577 622 
Commercial mortgage loans182 1,351 1,533 67 1,547 1,614 
Policy loans— 1,211 1,211 — 1,218 1,218 
Other long-term investments— 4,181 4,181 — 3,728 3,728 
Short-term investments206 — 206 139 — 139 
Total$1,009 $19,339 $20,348 
Investments classified as assets of businesses held for sale (1)
(84)(1,354)(1,438)
Investments per Consolidated Balance Sheets$925 $17,985 $18,910 $905 $16,288 $17,193 
(1) Investments related to the HCSC transaction that were held for sale as of December 31, 2023. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long term investments.
Investment Portfolio
Debt 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. Prior to the adoption of LDTI on January 1, 2023, net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business was reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive loss. See Note 16 for impact to 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 14 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 as of December 31, 2023:
(In millions)Amortized
Cost		Fair
Value
Due in one year or less$622 $605 
Due after one year through five years3,914 3,761 
Due after five years through ten years3,194 3,005 
Due after ten years2,251 2,119 
Mortgage and other asset-backed securities398 365 
Total$10,379 $9,855 
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.
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, 2023
Federal government and agency$251 $— $24 $(8)$267 
State and local government37 — 2 (1)38 
Foreign government355 — 10 (13)352 
Corporate9,338 (33)158 (630)8,833 
Mortgage and other asset-backed398 — 1 (34)365 
Total$10,379 $(33)$195 $(686)$9,855 
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 
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, 2023December 31, 2022
(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$330 $338 $(8)142$5,533 $6,127 $(594)1,659 
Below investment grade161 170 (9)135887 964 (77)1,287 
More than one year
Investment grade5,441 6,036 (595)1,5901,151 1,487 (336)462 
Below investment grade701 775 (74)486330 382 (52)369 
Total$6,633 $7,319 $(686)2,353 $7,901 $8,960 $(1,059)3,777 
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, 2023 or 2022.
December 31, 2023 December 31, 2022
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$656 $51 $673 $138 
Equity securities with no readily determinable fair value3,248 3,311 380 484 
Total$3,904 $3,362 $1,053 $622 
In 2023, we became a minority owner in VillageMD by investing $2.7 billion in VillageMD preferred equity. VillageMD is a provider of primary, multi-specialty and urgent care services that is majority-owned by Walgreens Boots Alliance, Inc. These securities are included in Equity securities with no readily determinable fair value in the above table. A compounding dividend of 5.5% accrues annually on $2.2 billion of our cost basis in these shares. Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 95% of our investments in equity securities are in the health care sector.
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, 2023December 31, 2022
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$802 2.13$901 2.12
60% to 79%574 1.77564 1.73
80% to 100%157 0.65149 1.17
Total$1,533 1.8264 %$1,614 1.8960 %
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, 2023 and 2022 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 and certain 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 14 for additional information). The following table provides unfunded commitment and carrying value information for these investments. The Company expects to disburse approximately 25% of the committed amounts in 2024.

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 $253 million in 2023, $487 million in 2022 and $568 million in 2021.
Unfunded Commitments as of
Carrying Value as of December 31,
(In millions)20232022December 31, 2023
Real estate investments$1,606 $1,319 $712 
Securities partnerships2,400 2,166 2,085 
Other175 243 — 
Total$4,181 $3,728 $2,797 
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 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.
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 13. 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 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 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, 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.
The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of December 31, 2023 and December 31, 2022. The gross fair values of our derivative financial instruments are presented in Note 13 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, 2023December 31, 2022
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
$1,026 $1,083 
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 $1,500 
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
$415 $460 
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, 2023 or 2022.
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)202320222021
Debt securities$500 $572 $689 
Equity securities123 14 12 
Commercial mortgage loans65 59 60 
Policy loans60 59 63 
Other long-term investments123 390 758 
Short-term investments and cash339 115 26 
Total investment income1,210 1,209 1,608 
Less investment expenses44 54 59 
Net investment income$1,166 $1,155 $1,549 
Realized Investment Gains and Losses
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. With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business. Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.
The following realized gains and losses on investments exclude 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)202320222021
Net realized investment (losses) gains, excluding credit loss expense and asset write-downs
$(68)$(451)$196 
Credit (loss) / recovery and other investment write-down (losses)(10)(36)2 
Net realized investment (losses) gains, before income taxes
$(78)$(487)$198 
Net realized investment losses for the years ended December 31, 2023 and December 31, 2022 were primarily due to mark-to-market losses on a strategic health care equity securities investment.
v3.24.0.1
Fair Value Measurements
 12 Months Ended
Dec. 31, 2023
Fair Value Disclosures [Abstract]  
Fair Value Measurements
Note 13 – 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. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 10E to the Consolidated Financial Statements. 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, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022
Financial assets at fair value
Debt securities
Federal government and agency$130 $147 $137 $165 $— $— $267 $312 
State and local government— — 38 41 — — 38 41 
Foreign government— — 352 365 — — 352 365 
Corporate
— — 8,432 8,394 401 412 8,833 8,806 
Mortgage and other asset-backed— — 319 313 46 35 365 348 
Total debt securities130 147 9,278 9,278 447 447 9,855 9,872 
Equity securities (1)
4 6 47 132 — — 51 138 
Short-term investments— — 206 139 — — 206 139 
Derivative assets— — 131 230 1 1 132 231 
Financial liabilities at fair value
Derivative liabilities$— $— $4 $— $— $— $4 $— 
(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, 2023 or December 31, 2022. The nature and use of these derivative financial instruments are described in Note 12.
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. Additionally, as discussed in Note 10E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.
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 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, 2023December 31, 2022Unobservable Input December 31, 2023December 31, 2023December 31, 2022
Debt securities
Corporate$401 $412 Liquidity
70 - 1235 (310)
bps
60 - 1060 (270)
bps
Mortgage and other asset-backed securities46 35 Liquidity
95 - 640 (310)
bps
105 - 520 (310)
bps
Total Level 3 debt securities$447 $447 

An 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)20232022
Debt and Equity Securities
Beginning balance$447 $796 
(Losses) gains included in Shareholders' net income
(2)11 
Gains (losses) included in Other comprehensive loss
8 (59)
Purchases, sales and settlements
Purchases10 158 
Settlements(52)(207)
Total purchases, sales and settlements(42)(49)
Transfers into/(out of) Level 3
Transfers into Level 395 124 
Transfers out of Level 3(59)(376)
Total transfers into/(out of) Level 336 (252)
Ending balance$447 $447 
Total losses included in Shareholders' net income attributable to instruments held at the reporting date
$(2)$(2)
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period
$3 $(60)

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, net of tax in the tables above are reflected in Net unrealized appreciation (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 2023 and 2022 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. The separate account activity for the year ended December 31, 2023 and 2022 was primarily driven by changes in the market values of the underlying separate account investments.
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, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022
Guaranteed separate accounts (See Note 24)
$226 $203 $352 $382 $— $— $578 $585 
Non-guaranteed separate accounts (1)
158 211 5,797 5,522 217 203 6,172 5,936 
Subtotal$384 $414 $6,149 $5,904 $217 $203 6,750 6,521 
Non-guaranteed separate accounts priced at NAV as a practical expedient (1)
680 757 
Total$7,430 $7,278 
(1)Non-guaranteed separate accounts include $4.0 billion as of December 31, 2023 and December 31, 2022 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of December 31, 2023 and December 31, 2022.
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, 2023 or 2022.
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, 2023Redemption Frequency
(if currently eligible)		Redemption Notice
Period
(In millions)December 31, 2023December 31, 2022
Securities partnerships$419 $451 $254 Not applicableNot applicable
Real estate funds258 302 — Quarterly
30 - 90 days
Hedge funds3 4 — Up to annually, varying by fund
30 - 90 days
Total$680 $757 $254 
As of December 31, 2023, 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, 2023 and 2022, realized investment gains and losses, including those from impairments recognized and observable price changes, 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, 2023December 31, 2022
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,430 $1,533 $1,491 $1,614 
Long-term debt, including current maturities, excluding finance leasesLevel 2$28,033 $29,585 $28,653 $30,994 
v3.24.0.1
Variable Interest Entities
 12 Months Ended
Dec. 31, 2023
Variable Interest Entities [Abstract]  
Variable Interest Entities
Note 14 – 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, 2023 or 2022.
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 190 limited partnerships that have a carrying value of $2.9 billion as of December 31, 2023 reported in other long-term investments. As of December 31, 2023, we have commitments to contribute an additional $2.6 billion to these entities and the Company's maximum exposure to loss from these investments is $5.5 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 8% of the partnership ownership interests. See Note 12 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 $488 million as of December 31, 2023.

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. As of December 31, 2023, the Company's maximum exposure to loss is $0.5 billion from certain asset-backed and corporate securities and $0.9 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, 2023.
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.
v3.24.0.1
Collectively Significant Operating Unconsolidated Subsidiaries
 12 Months Ended
Dec. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]  
Collectively Significant Operating Unconsolidated Subsidiaries
Note 15 – 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 12), 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 $911 million as of December 31, 2023 and $734 million as of December 31, 2022, of which $214 million as of December 31, 2023 and $602 million as of December 31, 2022 related to our joint venture in China. Total Accumulated Other Comprehensive Income ("AOCI") includes losses of $510 million as of December 31, 2023 and $88 million as of December 31, 2022 related to the Company's share from unconsolidated entities reported on the equity method primarily driven by the requirement to update discount rate assumptions for certain long-duration liabilities following the adoption of LDTI (discussed in Note 2 to the Consolidated Financial Statements).
For the years ended December 31, 2023, 2022 and 2021, 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. Prior period operating joint venture amounts have been retrospectively restated to reflect the adoption of amended accounting guidance for long-duration insurance contracts, as discussed in Note 2 to the Consolidated Financial Statements.
For the Years Ended December 31,
(In millions)202320222021
Revenues$5,962 $4,665 $3,750 
Net income (loss)$98 $(12)$180 
(In millions)December 31, 2023December 31, 2022
Total assets$26,681 $21,026 
Total liabilities$25,534 $19,462 
v3.24.0.1
Accumulated Other Comprehensive Income (Loss)
 12 Months Ended
Dec. 31, 2023
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Accumulated Other Comprehensive Income (Loss)
Note 16 – Accumulated Other Comprehensive Income (Loss)
AOCI includes net unrealized (depreciation) appreciation on securities and derivatives, change in discount rate and instrument specific credit risk for certain long-duration insurance contractholder liabilities (Note 10 to the Consolidated Financial Statements), foreign currency translation and the net postretirement benefits liability adjustment. AOCI includes the Company's share from unconsolidated entities reported on 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.

Shareholders' other comprehensive (loss), net of tax, for the years ended 2023, 2022 and 2021, is primarily driven by the change in discount rates for certain long-duration liabilities, unrealized changes in the market values of securities and derivatives and changes in postretirement benefits liabilities, including the impacts from unconsolidated entities reported on the equity method.
Changes in the components of AOCI, including the restatement for amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements), are as follows:
For the Years Ended December 31,
(In millions)202320222021
Securities and Derivatives
Beginning balance, as previously disclosed$900 
Cumulative effect of accounting for Long-duration Insurance Contracts guidance (ASU 2018-12)668 
Beginning balance, as retrospectively restated$(332)$1,266 1,568 
Unrealized appreciation (depreciation) on securities and derivatives620 (2,274)(335)
Tax (expense) benefit(146)467 52 
Net unrealized appreciation (depreciation) on securities and derivatives474 (1,807)(283)
Reclassification adjustment for losses included in Shareholders' net income ((Loss) gain on sale of businesses)— 172 — 
Reclassification adjustment for losses (gains) included in Shareholders' net income (Net realized investment (losses) gains)38 47 (24)
Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses)(1)— — 
Reclassification adjustment for tax (benefit) expense included in Shareholders' net income(8)(10)5 
Net losses (gains) reclassified from AOCI to Shareholders' net income29 209 (19)
Other comprehensive income (loss), net of tax503 (1,598)(302)
Ending balance$171 $(332)$1,266 

For the Years Ended December 31,
(In millions)202320222021
Net long-duration insurance and contractholder liabilities measurement adjustments (1)
Beginning balance, as previously disclosed$— 
Cumulative effect of accounting for Long-duration Insurance Contracts guidance (ASU 2018-12)(832)
Beginning balance, as retrospectively restated$(256)$(765)(832)
Current period change in discount rate for certain long-duration liabilities(913)642 59 
Tax benefit (expense)222 (122)(3)
Net current period change in discount rate for certain long-duration liabilities(691)520 56 
Current period change in instrument-specific credit risk for market risk benefits(29)(14)13 
Tax benefit (expense)5 3 (2)
Net current period change in instrument-specific credit risk for market risk benefits(24)(11)11 
Other comprehensive (loss) income, net of tax(715)509 67 
Ending balance$(971)$(256)$(765)
(1)Established upon the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
For the Years Ended December 31,
(In millions)202320222021
Translation of foreign currencies
Beginning balance, as retrospectively restated$(154)$(233)$(15)
Translation of foreign currencies— (277)(213)
Tax benefit (expense)5 (33)(19)
Net translation of foreign currencies5 (310)(232)
Reclassification adjustment for losses included in Net income ((Loss) gain on sale of businesses)— 358 — 
Reclassification adjustment for tax expense included in Net income— 29 — 
Net translation losses reclassified from AOCI to Net income— 387 — 
Translation of foreign currencies— 81 (213)
Tax benefit (expense)5 (4)(19)
Other comprehensive income (loss), net of tax5 77 (232)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests— (2)(14)
Shareholders' other comprehensive income (loss), net of tax5 79 (218)
Ending balance$(149)$(154)$(233)
For the Years Ended December 31,
(In millions)202320222021
Postretirement benefits liability
Beginning balance$(916)$(1,336)$(1,746)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)46 65 85 
Reclassification adjustment for (gains) included in Shareholders' net income ((Loss) gain on sale of businesses)— (1)— 
Reclassification adjustment for settlement (Interest expense and other)— — 4 
Reclassification adjustment for tax (benefit) included in Shareholders' net income(11)(16)(21)
Net adjustments reclassified from AOCI to Shareholders' net income35 48 68 
Valuation update(46)487 448 
Tax benefit (expense)12 (115)(106)
Net change due to valuation update(34)372 342 
Other comprehensive income, net of tax1 420 410 
Ending balance$(915)$(916)$(1,336)

For the Years Ended December 31,
(In millions)202320222021
Total Accumulated other comprehensive loss
Beginning balance, as previously disclosed$(861)
Cumulative effect of accounting for Long-duration Insurance Contracts guidance (ASU 2018-12)(164)
Beginning balance, as retrospectively restated$(1,658)$(1,068)(1,025)
Shareholders' other comprehensive (loss), net of tax(206)(590)(43)
Ending balance$(1,864)$(1,658)$(1,068)
v3.24.0.1
Organizational Efficiency Plan
 12 Months Ended
Dec. 31, 2023
Restructuring and Related Activities [Abstract]  
Organizational Efficiency Plan
Note 17 – Organizational Efficiency Plan
During the fourth quarter of 2023, the Company approved a strategic realignment to drive greater operating effectiveness and efficiency. This plan positions us to be more efficient and focused to deliver differentiated value and services to our clients and customers.

We recognized a charge in Selling, general and administrative expenses of $252 million, pre-tax ($193 million, after-tax). This charge included $232 million of accrued expenses primarily for severance costs related to headcount reductions, as well as, $20 million of one-time expenses related to abandonment of leased assets and impairment of property and equipment. We expect substantially all of the accrued liability to be paid by the end of 2024.

The following table summarizes a roll forward of the accrued liability recorded in Accrued expenses and other liabilities:
(In millions) 
Balance, December 31, 2022
$— 
Fourth quarter 2023 charge
232 
2023 payments
(30)
Balance, December 31, 2023
$202 
v3.24.0.1
Pension
 12 Months Ended
Dec. 31, 2023
Retirement Benefits [Abstract]  
Pension
Note 18 – 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 $4.0 billion, compared with a fair value of approximately $4.1 billion at December 31, 2023.

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)20232022
Change in benefit obligation
Benefit obligation, January 1$3,948 $5,223 
Service cost1 2 
Interest cost204 140 
Actuarial losses (gains), net (1)
93 (1,094)
Benefits paid from plan assets(294)(296)
Other
(18)(27)
Benefit obligation, December 313,934 3,948 
Change in plan assets
Fair value of plan assets, January 14,186 4,846 
Actual return on plan assets246 (366)
Benefits paid(294)(296)
Contributions— 2 
Fair value of plan assets, December 314,138 4,186 
Funded status$204 $238 
Amounts presented in Consolidated Balance Sheets
Other assets
$204 $238 
(1) 2023 losses reflect a decrease in the discount rate while 2022 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 2023. For 2024, 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)
2024$319 
2025$316 
2026$317 
2027$314 
2028$311 
2029 - 2033$1,484 

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, 2023December 31, 2022
Unrecognized net (losses)
$(1,207)$(1,208)
Unrecognized prior service cost(4)(5)
Postretirement benefits liability adjustment$(1,211)$(1,213)
C.Cost of Our Plans
Net pension cost was as follows:
For the Years Ended December 31,
(In millions)202320222021
Service cost$1 $2 $2 
Interest cost204 140 132 
Expected long-term return on plan assets(204)(272)(269)
Amortization of:
Prior actuarial losses, net52 89 78 
Settlement loss— — 4 
Net (benefit) cost$53 $(41)$(53)
D.Assumptions Used for Pension
For the Years Ended December 31,
 20232022
Discount rate:
Pension benefit obligation5.10%5.43%
Pension benefit cost5.43%2.82%
Expected long-term return on plan assets:
Pension benefit cost6.50%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, 2023, 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 $0.1 billion invested in funds of unaffiliated investment managers.
The fair values of pension assets by category are as follows:
(In millions)December 31, 2023December 31, 2022
Debt securities:
Federal government and agency$12 $11 
Corporate2,780 2,349 
Asset-backed121 109 
Fund investments278 478 
Total debt securities3,191 2,947 
Equity securities:
Domestic27 89 
International, including funds and pooled separate accounts (1)
6 35 
Total equity securities33 124 
Securities partnerships419 452 
Real estate funds, including pooled separate accounts (1)
270 315 
Commercial mortgage loans46 63 
Guaranteed deposit account contract48 50 
Cash equivalents and other current assets, net131 235 
Total pension assets at fair value$4,138 $4,186 
(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 90% fixed income and 10% 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. The Company will evaluate further allocation changes to equity securities, other investments and fixed income securities as funding levels change.

See Note 13 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. All domestic equity securities and international equity funds within pension assets are classified as 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 13 for additional disclosures related to these assets invested in the separate accounts of the Company's subsidiary. Certain securities as described in Note 13, 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)202320222021
Expense$296 $274 $268 
v3.24.0.1
Employee Incentive Plans
 12 Months Ended
Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]  
Employee Incentive Plans
Note 19 – 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, 2023December 31, 2022December 31, 2021
Common shares available for award14.4 16.6 19.1 
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:
 202320222021
Dividend yield1.58 %1.98 %1.85 %
Expected volatility30.0 %30.0 %30.0 %
Risk-free interest rate3.6 %1.6 %0.5 %
Expected option life4.7 years4.5 years4.5 years
Weighted average fair value of options$79.66 $50.61 $44.84 
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,
202320222021
(Options in thousands)OptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise Price
Outstanding - January 16,992 $186.54 8,490 $169.47 9,742 $152.40 
Granted915 $294.37 1,375 $226.95 1,524 $213.81 
Exercised(1,080)$174.66 (2,617)$149.97 (2,584)$129.08 
Expired or canceled(131)$246.95 (256)$211.22 (192)$199.10 
Outstanding - December 316,696 $202.02 6,992 $186.54 8,490 $169.47 
Options exercisable at year-end4,616 $179.28 4,410 $168.97 5,612 $152.92 
Compensation expense of $67 million related to unvested stock options at December 31, 2023 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)202320222021
Intrinsic value of options exercised$126 $313 $268 
Cash received for options exercised$187 $389 $326 
Tax benefit from options exercised$17 $47 $50 
The following table summarizes information for outstanding common stock options:
December 31, 2023
 Options
Outstanding		Options
Exercisable
Number (in thousands)6,696 4,616 
Total intrinsic value (in millions)$652 $555 
Weighted average exercise price$202.02 $179.28 
Weighted average remaining contractual life5.9 years4.7 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,
202320222021
(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 11,535 $219.25 1,524 $202.85 1,600 $186.12 
Awarded700 $294.60 876 $229.60 899 $213.82 
Vested(759)$214.70 (714)$197.83 (866)$184.07 
Forfeited(72)$256.24 (151)$215.02 (109)$197.01 
Outstanding - December 311,404 $257.38 1,535 $219.25 1,524 $202.85 
The fair value of vested restricted stock at the vesting date was as follows:
For the Years Ended December 31,
(In millions)202320222021
Fair value of vested restricted stock$220 $167 $183 
Approximately 8,900 employees held 1.4 million restricted stock awards at the end of 2023 with $196 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,
 202320222021
(Awards in thousands)SharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award Date
Outstanding - January 1780 $212.68 860 $197.07 808 $190.02 
Awarded219 $293.85 294 $230.69 331 $213.90 
Vested(250)$191.78 (261)$183.60 (206)$196.29 
Forfeited(63)$237.50 (113)$207.75 (73)$197.38 
Outstanding - December 31686 $243.90 780 $212.68 860 $197.07 
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, 2023, 2022 and 2021 was $329.11, $258.37 and $239.57, respectively.
The fair value of vested SPSs at the vesting date was as follows:
For the Years Ended December 31,
 202320222021
(Shares in thousands; $ in millions)SharesFair ValueSharesFair ValueSharesFair Value
Shares of The Cigna Group common stock distributed upon SPS vesting257 $76 137 $31 243 $51 
Approximately 600 employees held 686,000 SPSs at the end of 2023 and $61 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 2024 and 2025.
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 income tax expense when stock options are exercised, or when restricted stock and SPSs vest.
For the Years Ended December 31,
(In millions)202320222021
Total compensation cost for shared-based awards$286 $264 $268 
Tax benefits recognized$92 $80 $73 
v3.24.0.1
Goodwill, Other Intangibles and Property and Equipment
 12 Months Ended
Dec. 31, 2023
Goodwill Other Intangibles And Property And Equipment [Abstract]  
Goodwill, Other Intangibles, and Property and Equipment
Note 20 – 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. Following a change in reporting units or held for sale determination, goodwill is allocated using relative fair value. 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, 2022 (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 
Goodwill transferred to assets of businesses held for sale— (1,553)— (1,553)
Impact of foreign currency translation and other adjustments— 1 — 1 
Goodwill at December 31, 2023
$35,130 $9,129 $— $44,259 
(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, trademarks and provider networks. 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.
Components of other assets, including other intangibles. Other intangible assets were comprised of the following:
(In millions)CostAccumulated AmortizationNet Carrying Value
December 31, 2023   
Customer relationships$29,978 $7,645 $22,333 
Trade Name - Express Scripts8,400 8,400 
Other317 110 207 
Other intangible assets38,695 7,755 30,940 
Value of business acquired ("VOBA" reported in Other assets)
211 142 69 
Total (1)
$38,906 $7,897 $31,009 
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 (reported in Other assets)
210 133 77 
Total$38,932 $6,363 $32,569 
(1) Includes $69 million of VOBA and $77 million of Other intangible assets classified as assets of businesses held for sale.
The Company has indefinite-lived intangible assets totaling $8.5 billion at December 31, 2023 and December 31, 2022, largely consisting of the Express Scripts trade name.
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 and internally developed software, three to five 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, 2023   
Internal-use software$10,155 $7,161 $2,994 
Other property and equipment2,282 1,405 877 
Total property and equipment (1)
$12,437 $8,566 $3,871 
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 
(1) Includes $176 million of Property and equipment net carrying value classified as assets of businesses held for sale.
Components of depreciation and amortization. Depreciation and amortization expense was comprised of the following:
For the Years Ended December 31,
(In millions)202320222021
Internal-use software$1,216 $1,068 $1,097 
Other property and equipment260 251 253 
Value of business acquired (reported in Other assets)
7 12 25 
Other intangibles1,552 1,606 1,548 
Total depreciation and amortization$3,035 $2,937 $2,923 
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
2024$2,892 
2025$2,357 
2026$1,803 
2027$1,559 
2028$1,484 
v3.24.0.1
Leases
 12 Months Ended
Dec. 31, 2023
Leases [Abstract]  
Leases
Note 21 – 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)202320222021
Operating lease cost$115 $124 $170 
Finance lease cost:
Amortization of ROU assets41 33 22 
Interest on lease liabilities4 2 2 
Total finance lease cost45 35 24 
Variable lease cost38 41 39 
Total lease cost$198 $200 $233 

Supplemental cash flow information related to leases was as follows:
For the Years Ended December 31,
(In millions)202320222021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$132 $148 $167 
Operating cash outflows from finance leases$4 $2 $2 
Financing cash outflows from finance leases$39 $33 $22 
 
ROU assets obtained in exchange for lease obligations:
Operating leases$103 $43 $122 
Finance leases$48 $84 $20 
Operating and finance lease ROU assets and lease liabilities were as follows:
(In millions)December 31, 2023December 31, 2022
Operating leases:
Operating lease ROU assets in Other assets
$370 $375 
Accrued expenses and other liabilities$105 $114 
Other non-current liabilities340 346 
Total operating lease liabilities$445 $460 
Finance leases:
Property and equipment, gross$177 $145 
Accumulated depreciation(73)(48)
Property and equipment, net$104 $97 
Short-term debt$42 $33 
Long-term debt66 66 
Total finance lease liabilities$108 $99 
As of December 31, 2023, the weighted average remaining lease term was 6 years for operating leases and 3 years for finance leases, and the weighted average discount rate was 3.45% for operating leases and 4.29% for finance leases.
Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2024$110 $46 
2025102 38 
202683 19 
202763 6 
202841 6 
Thereafter98 — 
Total lease payments497 115 
Less: imputed interest52 7 
Total$445 $108 
Leases
Note 21 – 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)202320222021
Operating lease cost$115 $124 $170 
Finance lease cost:
Amortization of ROU assets41 33 22 
Interest on lease liabilities4 2 2 
Total finance lease cost45 35 24 
Variable lease cost38 41 39 
Total lease cost$198 $200 $233 

Supplemental cash flow information related to leases was as follows:
For the Years Ended December 31,
(In millions)202320222021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$132 $148 $167 
Operating cash outflows from finance leases$4 $2 $2 
Financing cash outflows from finance leases$39 $33 $22 
 
ROU assets obtained in exchange for lease obligations:
Operating leases$103 $43 $122 
Finance leases$48 $84 $20 
Operating and finance lease ROU assets and lease liabilities were as follows:
(In millions)December 31, 2023December 31, 2022
Operating leases:
Operating lease ROU assets in Other assets
$370 $375 
Accrued expenses and other liabilities$105 $114 
Other non-current liabilities340 346 
Total operating lease liabilities$445 $460 
Finance leases:
Property and equipment, gross$177 $145 
Accumulated depreciation(73)(48)
Property and equipment, net$104 $97 
Short-term debt$42 $33 
Long-term debt66 66 
Total finance lease liabilities$108 $99 
As of December 31, 2023, the weighted average remaining lease term was 6 years for operating leases and 3 years for finance leases, and the weighted average discount rate was 3.45% for operating leases and 4.29% for finance leases.
Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2024$110 $46 
2025102 38 
202683 19 
202763 6 
202841 6 
Thereafter98 — 
Total lease payments497 115 
Less: imputed interest52 7 
Total$445 $108 
v3.24.0.1
Shareholders Equity and Dividend Restrictions
 12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Shareholders' Equity And Dividend Restrictions
Note 22 – 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)202320222021
Net income$5.3 $5.7 $3.4 
Surplus$14.9 $16.4 $13.3 
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, 2023
Minimum statutory surplus required by regulators (1)
$4.8 
Investments on deposit with regulatory bodies$0.3 
Maximum dividend distributions permitted in 2024 without regulatory approval
$2.1 
Maximum loans to the parent company permitted without regulatory approval$1.4 
Restricted GAAP net assets of The Cigna Group's subsidiaries$12.3 
(1) Excludes amounts associated with foreign operated equity method joint ventures.

Permitted practices used by the Company's insurance subsidiaries in 2023 that differed from prescribed regulatory accounting had an immaterial impact on statutory surplus.
Undistributed earnings for equity method investments are $1.0 billion as of December 31, 2023
v3.24.0.1
Income Taxes
 12 Months Ended
Dec. 31, 2023
Income Tax Disclosure [Abstract]  
Income Taxes
Note 23 – 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)202320222021
Current taxes
U.S. income taxes$1,459 $1,679 $1,267 
Foreign income taxes161 219 207 
State income taxes180 189 112 
Total current taxes1,800 2,087 1,586 
Deferred taxes (benefits)
U.S. income tax benefits
(533)(275)(163)
Foreign income (tax benefits) taxes
(1,046)(28)69 
State income tax benefits
(80)(169)(122)
Total deferred tax benefits
(1,659)(472)(216)
Total income taxes$141 $1,615 $1,370 
Total income taxes were different from the amount computed using the nominal federal income tax rate for the following reasons:
For the Years Ended December 31,
 202320222021
(In millions)$%$%$%
Tax expense at nominal rate$1,158 21.0 %$1,763 21.0 %$1,426 21.0 %
Impact of sale of businesses— — (37)(0.4)— — 
Impact of businesses held for sale(213)(3.9)— — — — 
Effect of foreign earnings(173)(3.1)(96)(1.2)(33)(0.5)
State income tax (benefit), net of federal income tax benefit
(39)(0.7)16 0.2 (9)(0.1)
Swiss tax attributes(1,674)(30.4)— — — — 
Other foreign tax attributes(153)(2.8)— — — — 
Change in valuation allowance1,290 23.4 — — — — 
Other(55)(0.9)(31)(0.4)(14)(0.2)
Total income taxes$141 2.6 %$1,615 19.2 %$1,370 20.2 %
Consolidated pre-tax income from the Company's foreign operations was approximately 48% of the Company's pre-tax income in 2023, 46% in 2022 and 26% in 2021. The increase over 2022 is primarily driven by an increase to the Company's international pharmaceutical operations, partially offset by a reduction in earnings from the sold entities.
Foreign Jurisdiction Tax Attributes. Impacting the effective tax rate for the year ended December 31, 2023 was the recording of the Company's net deferred tax asset associated with foreign tax law changes and agreements in certain tax jurisdictions. The Company established deferred tax assets of approximately $1.8 billion associated with the foreign tax attributes and a related $772 million valuation allowance against these deferred tax assets based on projections of future earnings and requirements to utilize the assets within certain time periods. It is possible in future periods that the Company may revalue these net deferred tax assets due to modifications in certain assumptions such as forecasted future earnings.
Sale of Medicare Advantage and Related Businesses. The Company recorded $584 million of deferred tax benefits and an equal amount of valuation allowance in connection with the HCSC transaction. The valuation allowance has been recorded due to the uncertainty relative to the recovery of the deferred tax benefits as the Company does not currently have capital gain capacity to offset these capital losses.
B.Deferred Income Taxes
Deferred income tax assets and liabilities were as follows:
(In millions)December 31, 2023December 31, 2022
Deferred tax assets
Employee and retiree benefit plans$217 $189 
Other insurance and contractholder liabilities353 278 
Loss carryforwards200 205 
Deferred loss - sale of business584 — 
Other accrued liabilities244 265 
Policy acquisition expenses39 36 
Unrealized depreciation on investments and foreign currency translation81 159 
Foreign tax attributes1,827 — 
Other242 190 
Deferred tax assets before valuation allowance3,787 1,322 
Valuation allowance for deferred tax assets(1,498)(208)
Deferred tax assets, net of valuation allowance2,289 1,114 
Deferred tax liabilities
Depreciation and amortization371 512 
Acquisition-related basis differences8,105 8,347 
Other— 41 
Total deferred tax liabilities8,476 8,900 
Net deferred income tax liabilities(1)
$(6,187)$(7,786)
(1)Deferred tax liabilities, net in the Consolidated Balance Sheets as of December 31, 2023, excludes $1,055 million reported in Other assets and $69 million reported in liabilities of businesses held for sale.
Management believes that future results will be sufficient to realize a majority of the Company's gross deferred tax assets. As of December 31, 2023, we had approximately $218 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are partially 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 carry back losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any valuation allowance in the future. As of December 31, 2023, we had approximately $1.8 billion in DTAs associated with the foreign tax attributes as discussed above. We have determined that approximately $772 million valuation allowance against these DTAs is required based on the Company's taxable income projections and the requirement to utilize the assets within certain time periods. Additionally, the Company has $584 million of deferred tax assets and a full valuation allowance associated with the HCSC transaction, as discussed above. 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)202320222021
Balance at January 1,$1,343 $1,230 $1,210 
(Decrease) / Increase due to prior year positions(26)8 21 
Increase due to current year positions107 137 31 
Reduction related to settlements with taxing authorities(13)(4)(15)
Reduction related to lapse of applicable statute of limitations(12)(28)(17)
Balance at December 31,$1,399 $1,343 $1,230 
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 $220 million as of December 31, 2023, $176 million as of December 31, 2022 and $148 million as of December 31, 2021.
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 2014 for The Cigna Group's entities and 2010 for Express Scripts' entities.

Pillar Two. On December 15, 2022, the European Union ("EU") Member States formally adopted the EU's Pillar Two Directive, which generally provides for a minimum effective tax rate of 15%, as established by the Organization for Economic Co-operation and Development ("OECD") Pillar Two Framework that was supported by over 130 countries worldwide. The EU effective dates are January 1, 2024, and January 1, 2025, for different aspects of the directive. A significant number of other countries are also implementing similar legislation, and the OECD continues to release additional guidance on these rules. The Company is within the scope of the OECD Pillar Two model rules and continues to evaluate the potential impact on future periods of the Pillar Two Framework, pending legislative adoption by additional individual countries but expects the impact to not materially change its results from operations.
v3.24.0.1
Contingencies and Other Matters
 12 Months Ended
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]  
Contingencies and Other Matters
Note 24 – 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, 2023, 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, 2023. 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, 2023 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 laws or regulations 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 stated dollar amount or 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, 2023.
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, 2023.
Legal and Regulatory Matters
The 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 23.
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 accrual for the matter discussed below under "Litigation Matters" is not material. Due to numerous uncertain factors presented in this case, it is not possible to estimate an aggregate range of loss (if any) for this matter at this time. In light of the uncertainties involved in this matter, there is no assurance that its ultimate resolution will not exceed the amount currently accrued by the Company. An adverse outcome in this matter 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 this ongoing litigation matter 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, with alleged damages over $100 million. On November 1, 2023, the parties signed a settlement agreement pursuant to which Express Scripts agreed to resolve the service-related claims. The settlement agreement is not an admission of liability or fault by Express Scripts, the Company or its subsidiaries. Following the settlement, Elevance retains the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retains the ability to reassert its own pricing-related claims in the event any appeal by Elevance is successful. Elevance filed its Notice of Appeal of its pricing-related claims on December 12, 2023. Elevance’s opening appellate brief is due March 25, 2024.
v3.24.0.1
Segment Information
 12 Months Ended
Dec. 31, 2023
Segment Reporting [Abstract]  
Segment Information
Note 25 – Segment Information
See Note 1 to the Consolidated Financial Statements for a description of our segments. A description of our basis for reporting segment operating results is outlined below. Intersegment revenues primarily reflect pharmacy and care services 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,
202320222021
(In millions)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Loss (gain) on sale of businesses$1,499 $1,429 $(1,662)$(1,332)$— $— 
Charge for organizational efficiency plan
 (Selling, general and administrative expenses)		252 193 22 17 168 119 
Charges (benefits) associated with litigation matters
 (Selling, general and administrative expenses)		201 171 (28)(20)(27)(21)
Integration and transaction-related costs
 (Selling, general and administrative expenses)		45 35 135 103 169 71 
Deferred tax (benefits), net
 (Income taxes, less amount attributable to noncontrolling interests)		— (1,071)— — — — 
Debt extinguishment costs — — — — 141 110 
Total impact from special items$1,997 $757 $(1,533)$(1,232)$451 $279 
Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. See Note 2 to the Consolidated Financial Statements for further information. Prior period summarized segment information has been retrospectively adjusted to conform to this new basis of accounting. Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2023
Revenues from external customers$147,588 $46,219 $291 $1 $194,099 
Intersegment revenues5,670 4,332 — (10,002)
Net investment income
241 597 305 23 1,166 
Total revenues153,499 51,148 596 (9,978)195,265 
Net realized investment results from certain equity method investments
— 57 — — 57 
Adjusted revenues$153,499 $51,205 $596 $(9,978)$195,322 
Depreciation and amortization$2,438 $569 $3 $25 $3,035 
Income (loss) before income taxes
$4,768 $2,664 $76 $(1,995)$5,513 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(144)(2)— — (146)
Net realized investment losses (1)
— 133 2 — 135 
Amortization of acquired intangible assets1,774 45 — — 1,819 
Special items
Loss on sale of businesses— 1,481 18 — 1,499 
Charge for organizational efficiency plan— — — 252 252 
Charges associated with litigation matters44 157 — — 201 
Integration and transaction-related costs— — — 45 45 
Pre-tax adjusted income (loss) from operations$6,442 $4,478 $96 $(1,698)$9,318 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2022
Revenues from external customers
$135,786 $41,738 $1,839 $— $179,363 
Intersegment revenues4,463 2,535 — (6,998)
Net investment income
86 638 424 7 1,155 
Total revenues140,335 44,911 2,263 (6,991)180,518 
Net realized investment results from certain equity method investments— 126 — — 126 
Adjusted revenues$140,335 $45,037 $2,263 $(6,991)$180,644 
Depreciation and amortization$2,283 $638 $6 $10 $2,937 
Income (loss) before income taxes
$4,421 $3,470 $2,101 $(1,595)$8,397 
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 83 — 613 
Amortization of acquired intangible assets1,772 103 1 — 1,876 
Special items
(Gain) on sale of businesses— — (1,662)— (1,662)
Charge for organizational efficiency plan— — — 22 22 
(Benefits) associated with litigation matters— — — (28)(28)
Integration and transaction-related costs— — — 135 135 
Pre-tax adjusted income (loss) from operations$6,127 $4,099 $509 $(1,466)$9,269 
(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
2021
Revenues from external customers$127,692 $41,369 $3,459 $— $172,520 
Intersegment revenues4,203 2,271 — (6,474)
Net investment income (loss)
17 1,003 530 (1)1,549 
Total revenues131,912 44,643 3,989 (6,475)174,069 
Net realized investment results from certain equity method investments— — — — — 
Adjusted revenues$131,912 $44,643 $3,989 $(6,475)$174,069 
Depreciation and amortization$2,316 $551 $52 $4 $2,923 
Income (loss) before income taxes
$3,908 $3,804 $868 $(1,790)$6,790 
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)
4 (247)45 — (198)
Amortization of acquired intangible assets1,937 47 14 — 1,998 
Special items
Charge for organizational efficiency plan— — — 168 168 
(Benefits) associated with litigation matters— — — (27)(27)
Integration and transaction-related costs— — — 169 169 
Debt extinguishment costs — — — 141 141 
Pre-tax adjusted income (loss) from operations$5,818 $3,601 $903 $(1,339)$8,983 
(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. Prior period amounts have been retrospectively adjusted to reflect adoption of amended accounting guidance for long-duration insurance contracts (as discussed in Note 2 to the Consolidated Financial Statements) and to reflect the merger of the U.S. Commercial and U.S. Government operating segments into the U.S. Healthcare operating segment (as discussed in Note 1 to the Consolidated Financial Statements). The following table presents these revenues by product, premium and service type:
For the Years Ended December 31,
(In millions)202320222021
Products (Pharmacy revenues) (ASC 606)
Network revenues$67,514 $64,946 $64,992 
Home delivery and specialty revenues65,732 61,283 54,391 
Other revenues9,047 6,753 6,428 
Intercompany eliminations(5,050)(4,416)(4,398)
Total pharmacy revenues137,243 128,566 121,413 
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Healthcare
Employer insured16,490 15,199 14,315 
Medicare Advantage8,771 7,896 8,362 
Stop loss6,143 5,461 4,868 
Individual and Family Plans5,088 2,636 2,528 
Other4,095 3,996 5,076 
U.S. Healthcare
40,587 35,188 35,149 
International Health3,295 2,906 2,588 
Total Cigna Healthcare43,882 38,094 37,737 
Divested International businesses— 1,596 3,205 
Other281 225 221 
Intercompany eliminations74 1 (9)
Total premiums44,237 39,916 41,154 
Services (Fees) (ASC 606)
Evernorth Health Services
10,866 7,234 6,070 
Cigna Healthcare
6,566 6,053 5,743 
Other Operations
3 9 19 
Other revenues210 168 188 
Intercompany eliminations(5,026)(2,583)(2,067)
Total fees and other revenues12,619 10,881 9,953 
Total revenues from external customers$194,099 $179,363 $172,520 
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)202320222021
United States$189,840 $174,540 $166,626 
Foreign countries (1)
4,259 4,823 5,894 
Total revenues from external customers$194,099 $179,363 $172,520 
(1) The divested International businesses as described in Note 5 comprised of $1.6 billion and $3.2 billion in 2022 and 2021, respectively.
Revenues from U.S. Federal Government agencies, under a number of contracts, were 15% of consolidated revenues in 2023 and 14% in both 2022 and 2021. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments.
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group
 12 Months Ended
Dec. 31, 2023
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)2023
2022 (1)
2021 (1)
Revenues
Net investment income$22 $5 $— 
Intercompany interest income516 478 471 
Total revenues538 483 471 
Operating expenses
Selling, general and administrative expenses2 2 8 
Total operating expenses2 2 8 
Income from operations536 481 463 
Interest and other expense
(1,332)(1,215)(1,197)
Intercompany interest expense
(118)(147)(13)
Debt extinguishment costs— — (131)
Loss before income taxes(914)(881)(878)
Income tax benefits
(192)(183)(180)
Loss of Parent Company(722)(698)(698)
Equity in income of subsidiaries5,886 7,402 6,068 
Shareholders' net income5,164 6,704 5,370 
Shareholders' other comprehensive income (loss), net of tax
Net unrealized appreciation (depreciation) on securities and derivatives
503 (1,598)(302)
Net long-duration insurance and contractholder liabilities measurement adjustments(715)509 67 
Net translation gains (losses) of foreign currencies
5 79 (218)
Postretirement benefits liability adjustment1 420 410 
Shareholders' other comprehensive loss, net of tax
(206)(590)(43)
Shareholders' comprehensive income$4,958 $6,114 $5,327 
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 1 to Schedule 1 for further information. 

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)2023
2022 (1)
Assets  
Cash and cash equivalents$303 $115 
Other current assets6 6 
Total current assets309 121 
Investments in subsidiaries69,703 70,679 
Intercompany receivable11,475 10,366 
Other non-current assets77 99 
TOTAL ASSETS$81,564 $81,265 
Liabilities
Short-term debt$2,448 $2,749 
Other current liabilities1,854 1,295 
Total current liabilities4,302 4,044 
Long-term debt27,151 26,815 
Intercompany payable3,874 5,705 
Other non-current liabilities14 26 
TOTAL LIABILITIES35,341 36,590 
Shareholders' Equity
Common stock (shares issued, 400 and 398; authorized, 600)
4 4 
Additional paid-in capital30,669 30,233 
Accumulated other comprehensive loss(1,864)(1,658)
Retained earnings41,652 37,940 
Less treasury stock, at cost(24,238)(21,844)
TOTAL SHAREHOLDERS' EQUITY46,223 44,675 
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY$81,564 $81,265 
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 1 to Schedule 1 for further information.

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)2023
2022 (1)
2021 (1)
Cash Flows from Operating Activities   
Shareholders' net income$5,164 $6,704 $5,370 
Adjustments to reconcile shareholders' net income
to net cash provided by operating activities
Equity in income of subsidiaries(5,886)(7,402)(6,068)
Debt extinguishment costs— — 131 
Dividends received from subsidiaries1,381 2,056 2,726 
Other liabilities540 5 184 
Other, net640 298 439 
NET CASH PROVIDED BY OPERATING ACTIVITIES
1,839 1,661 2,782 
Cash Flows from Investing Activities
Net change in amounts due from affiliates622 (901)(1,007)
Net proceeds from short-term investments sold (purchased)
— 99 (50)
NET CASH PROVIDED BY (USED IN) INVESTING ACTIVITIES
622 (802)(1,057)
Cash Flows from Financing Activities
Net change in amounts due to affiliates1,473 10,392 2,062 
Net change in commercial paper1,237 (2,027)997 
Payments for debt extinguishment— — (126)
Repayment of long-term debt(2,822)(430)(4,199)
Net proceeds on issuance of long-term debt1,491 — 4,260 
Issuance of common stock187 389 326 
Common dividends paid(1,450)(1,384)(1,341)
Repurchase of common stock(2,284)(7,607)(7,742)
Tax withholding on stock compensation and other(110)(73)(86)
NET CASH USED IN FINANCING ACTIVITIES
(2,278)(740)(5,849)
Net increase (decrease) in cash, cash equivalents and restricted cash
183 119 (4,124)
Cash, cash equivalents and restricted cash, beginning of year152 33 4,157 
Cash, cash equivalents and restricted cash, end of year (2)
$335 $152 $33 
Noncash Investing and Financing Activities:
    Net amounts due to/(from) affiliates settled through capital transactions(5,221)(5,037)(8,429)
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 1 to Schedule 1 for further information.
(2) Includes restricted cash reported in Other non-current assets as of December 31, 2023 and 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. On January 1, 2023, The Cigna Group and its subsidiaries adopted Targeted Improvements to the Accounting for Long-Duration Contracts, Accounting Standards Update ("ASU") 2018-12 and related amendments. See Note 2 - Summary of significant accounting policies included in Part II, Item 8 of this Form 10-K for a description of the key provisions and impacts.
The Cigna Group, through its predecessor companies, was incorporated in Delaware in 1981. Cigna Corporation was renamed The Cigna Group in February 2023.
Note 2 - See Note 8 – 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, 2023, there were no outstanding balances under these revolving credit agreements.
In April 2023, The Cigna Group entered into the following revolving credit agreements (the "Credit Agreements"):
•a $4.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2028 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 $4.0 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 364-day revolving credit agreement that will mature in April 2024. 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 both 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 two facilities is diversified among 21 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 2027, a $1.0 billion three-year revolving credit agreement maturing on April 2025 and a $1.0 billion 364-day revolving credit agreement maturing in April 2023.

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. The commercial paper program had approximately
$1.2 billion outstanding at December 31, 2023 and an average interest rate of 5.63%.
Long-Term Debt
Debt Issuance and Debt Tender Offers. On February 5, 2024, we issued $4.5 billion of new senior notes. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We intend to use the remaining net proceeds to fund the repayment of our senior notes maturing in March 2024 and for general corporate purposes, which may include repayment of indebtedness and repurchases of shares of our common stock.
Concurrent with the debt issuance, The Company and its subsidiaries commenced tender offers to purchase for cash up to $2.25 billion in aggregate principal amount of outstanding notes, which included any and all of the $1.0 billion senior notes due June 2024. Following the early tender results, we increased the tender offers to up to $2.55 billion. On February 22, 2024, we purchased $1.8 billion principal amount of notes at early settlement of the tender offers. The tender offers will expire on March 5, 2024.

On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance were used for general
corporate purposes, and included repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

PrincipalMaturity DateInterest RateNet Proceeds
$700 million (1)
March 15, 20265.685%$698 million
$800 million (2)
March 15, 20335.400%$796 million
(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.
(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.
Debt Maturities. Maturities of the Company's long-term debt are as follows and exclude the impacts of the 2024 debt issuance and debt tender offers discussed above.
(In millions) 
2024$1,214 
2025$2,957 
2026$2,734 
2027$2,056 
2028$3,800 
Maturities after 2028$15,091 

Debt Covenants. The Company was in compliance with its debt covenants as of December 31, 2023.

Note 3 - The Company's intercompany receivables consist primarily of net intercompany loan amounts due from Evernorth Health, Inc. of $8.5 billion as of December 31, 2023 and $8.3 billion as of December 31, 2022. Interest income on the loan receivable was accrued at an average rate of 5.21% in 2023.
The Company's intercompany payables primarily reflect intercompany balances related to cash pooling arrangements as well as net intercompany loan borrowing from three indirect wholly-owned subsidiaries as of December 31, 2023. Interest expense on the loan payable was accrued at an average rate of 3.65% in 2023.
Note 4 - The Company guaranteed approximately $2.9 billion primarily related to intercompany indebtedness and financial obligations of certain direct and indirect wholly-owned subsidiaries. There were immaterial liabilities required for these guarantees as of December 31, 2023. Effective January 2024, the amount of such guarantees increased to $6.4 billion.
Note 5 - In February 2024, as part of our existing share repurchase program, we entered into separate ASR agreements ("2024 ASR agreements") with Deutsche Bank AG and Bank of America, N.A. (collectively, the "2024 Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the 2024 Counterparties and received an initial delivery of approximately 7.6 million shares of our common stock on February 15, 2024 representing $2.6 billion of the total remitted. We expect final settlement under the 2024 ASR agreements to occur in the second quarter of 2024.
v3.24.0.1
Schedule II - Valuation and Qualifying Accounts and Reserves
 12 Months Ended
Dec. 31, 2023
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
2023     
Investment asset valuation reserves
Available-for-sale debt securities$44 $11 $— $(22)$33 
Commercial mortgage loans$21 $10 $— $— $31 
Accounts receivable, net$160 $90 $1 $(88)$163 
Deferred tax asset valuation allowance$208 $1,286 $4 $— $1,498 
Reinsurance recoverables $35 $— $— $— $35 
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 (1)
$28 $7 $— $— $35 
2021
Investment asset valuation reserves
Available-for-sale debt securities$26 $29 $— $(32)$23 
Commercial mortgage loans$6 $— $— $— $6 
Accounts receivable, net$156 $54 $— $(84)$126 
Deferred tax asset valuation allowance $207 $23 $16 $— $246 
Reinsurance recoverables (1)
$30 $(2)$— $— $28 
(1)Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts ("LDTI") in 2023. See Note 2 to the Consolidated Financial Statements included in Part II, Item 8 of this Form 10-K for further information.
v3.24.0.1
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2023
Trading Arrangements, by Individual  
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
v3.24.0.1
Summary of Significant Accounting Policies (Policies)
 12 Months Ended
Dec. 31, 2023
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 related to the adoption of Targeted Improvements for the Accounting of Long-Duration Contracts, have been reclassified to conform to the current year presentation. See "Recent Accounting Pronouncements" below.
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
Targeted Improvements to the Accounting for Long-Duration Contracts, Accounting Standards Update ("ASU") 2018-12 and related amendments

The Cigna Group adopted LDTI January 1, 2023, which includes the following key provisions:

•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) are updated at least annually with the effect of changes in those assumptions remeasured retrospectively and reflected in current period net income.
•Discount rate assumptions are 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 are 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 ("MRB"), defined as protecting the contractholder from other-than-nominal capital market risk and exposing the insurer to that risk, are measured at fair value, with changes in fair value recognized in net income each period, except for the effect of the Company's change in nonperformance risk (own credit risk), which is recognized in other comprehensive income.
•Additional disclosures, including disaggregated roll forwards for the liability for future policy benefits, market risk benefits, contractholder deposit funds and DAC, as well as information about significant inputs, judgments, assumptions and methods used in measurement.
•The transition methods applied at adoption were:
•The liability for future policy benefits was remeasured using a modified retrospective approach applied to all outstanding contracts as of the beginning of the earliest period presented and was recognized in the opening balance of retained earnings. The impact of remeasuring the future policy benefits liability for the discount rate was recorded through accumulated other comprehensive income.
•DAC followed the transition method used for future policyholder benefits.
•Market risk benefits were remeasured at fair value at the beginning of the earliest period presented. The difference between this fair value and carrying value was recognized in the opening balance of retained earnings, excluding the effect of the Company's change in nonperformance risk (own credit risk), which was recognized in accumulated other comprehensive income.
Effects of adoption:

•The new guidance applies to our long-duration insurance products predominantly within the Cigna Healthcare segment and Other Operations.
•The cumulative effects of adopting the new standard were immaterial. The impacts were a decrease to January 1, 2021 Shareholders' equity of $139 million and an increase to Shareholders' net income for the years ended December 31, 2022 and December 31, 2021 of $36 million and $5 million, respectively. The corresponding impact to diluted earnings per share was an increase of $0.11 and $0.02 for the years ended December 31, 2022 and December 31, 2021, respectively.
•The prior periods within our Consolidated Statements of Income, Consolidated Statements of Comprehensive Income, Consolidated Balance Sheets, Consolidated Statements of Changes in Total Equity and Consolidated Statements of Cash Flows were restated to conform to the current presentation.
•Prior period balances in the Company's footnote disclosures have been updated to reflect adjustments resulting from the adoption of this standard. Refer to Note 10 to the Consolidated Financial Statements for the Company's updated accounting policies.
•It is possible that our income recognition pattern could change on a prospective basis for several reasons:
•Applying periodic assumption updates, versus the locked-in model, may change our timing of profit or loss recognition.
•DAC amortization is 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.

Additionally, in December 2022, the Financial Accounting Standards Board ("FASB") published ASU 2022-05, which simplified the retrospective adoption of LDTI by permitting 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.
Accounting Guidance Not Yet Adopted
There are no significant accounting pronouncements not yet adopted as of December 31, 2023.
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.
Other Assets (Current and Non-Current) Other current assets consist primarily of prepaid expenses, income tax receivables, accrued investment income and the current portion of reinsurance recoverables. Other assets (non-current) consist primarily of the Company's net deferred tax asset associated with foreign tax attributes (see Note 23) and the carrying value of our equity-method investments in business-related joint ventures in China, 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 15 for additional information on unconsolidated subsidiaries. Additionally, Other assets (non-current) includes operating lease right-of-use assets, various insurance-related assets and overfunded pension obligations (see Note 18). See Note 21 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 (see section G) and other liabilities arising from pharmacy contracts, management compensation, 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"), and amounts due to financial institutions under the accounts receivable factoring facility (see Note 3). Other non-current liabilities primarily include uncertain tax positions (see Note 23), amounts held for self-funded clients to cover the administration and payment of claims that may emerge post contract termination, lease liabilities (see Note 21) and underfunded pension obligations (see Note 18).
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 24.
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 $1.6 billion as of December 31, 2023 and $1.3 billion as of December 31, 2022.
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.
H.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 plans 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 plans 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 individual 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. Cigna Healthcare's long-duration premium revenues are associated with contracts that provide coverage greater than one year or are guaranteed to be renewed at the option of the policyholder beyond one year. 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 10 to the Consolidated Financial Statements for further information).
I.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 solutions, 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 $1.6 billion as of December 31, 2023 and $1.3 billion as of December 31, 2022.
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.
H.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 plans 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 plans 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 individual 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. Cigna Healthcare's long-duration premium revenues are associated with contracts that provide coverage greater than one year or are guaranteed to be renewed at the option of the policyholder beyond one year. 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 10 to the Consolidated Financial Statements for further information).
I.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 solutions, 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 estimated based on the Company's best information available at the time revenue is recognized.
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 Company entered into an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institutionThe transactions under the Facility are accounted for as a sale and recorded as a reduction to accounts receivable in the Consolidated Balance Sheets because control of, and risk related to, the accounts receivable are transferred to the financial institutionAmounts associated with this Facility are reflected within Net cash provided by operating activities in the Consolidated Statements of Cash Flows. Factoring fees paid under this Facility are reflected in Interest expense and other in the Consolidated Statements of Income.As of December 31, 2023, all sold accounts receivable have been collected from manufacturers, $515 million of which have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.
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.
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).
The Company evaluates certain insurance contracts subject to premium deficiency testing and recognizes a premium deficiency loss and corresponding reserve when expected claims costs, claims adjustment expenses, maintenance costs, and unamortized acquisition costs exceed unearned premium. Anticipated investment income is considered in the calculation of premium deficiency.
Unpaid Claims and Claims Expenses
This liability reflects estimates of the ultimate cost of claims that have been incurred but not reported, expected development on reported claims, claims 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.
Future Policy Benefits
Accounting Policy. Future policy benefits represent the present value of estimated future obligations, estimated using actuarial methods, for long-duration insurance policies and annuity products currently in force, consisting primarily of reserves for annuity contracts, life insurance benefits, and certain supplemental health products that are guaranteed renewable beyond one year.
Contracts are grouped at a level no higher than issue year, based on the original contract issue date, and at lower levels of disaggregation within each issue year for certain businesses to reflect factors including product type, plan type and currency. Management estimates these obligations based on assumptions for premiums, interest rates, mortality or morbidity, future claim adjudication expenses and surrenders. Mortality, morbidity and surrender assumptions are based on the Company's own experience and published actuarial tables, and are updated at least annually, to the extent changes in circumstances require. Interest rate assumptions are based on market-level yields for low credit risk fixed income instruments ("upper-medium grade fixed income instrument"). For interest accretion purposes, interest rates are fixed at the year of the cohort's inception, however for purposes of liability measurement, are updated to the current rate quarterly, with all changes in the interest rate from inception to current period reported through Accumulated other comprehensive loss. For contracts issued domestically, we use observable inputs from a published spot rate curve for terms up to 30 years and extrapolate for longer terms using a constant forward rate approach. For contracts issued by foreign operating entities with functional currencies other than the U.S. dollar, we use observable inputs to approximate a risk free rate and add a credit spread adjustment to align with a low-credit risk fixed income instrument. For terms beyond the last observable risk free rates, which vary by international market, we extrapolate to the ultimate forward rate assuming a constant credit spread.
For the annuity business, the premium paying period is shorter than the benefit coverage period, and a deferred profit liability is reported in future policy benefits representing gross premium received in excess of net premiums. Deferred profit liability is amortized based on expected future benefit payments.
Contractholder Deposit Funds Accounting Policy. Liabilities for contractholder deposit funds primarily include deposits received from customers for investment-related and universal life products as well as investment earnings on their fund balances in Other Operations. These liabilities are adjusted to reflect administrative charges and, for universal life fund balances, mortality charges. Interest credited on these funds is accrued ratably over the contract period.
Market Risk Benefits Accounting Policy. Variable annuity reinsurance liabilities are measured as MRBs at fair value, net of nonperformance risk, with fluctuations in value gross of reinsurer nonperformance risk reported in benefit expenses, while fluctuations in the Company's own nonperformance risk (own credit risk) are reported in Accumulated other comprehensive loss. Nonperformance risk reflects risk that a party might default and therefore not fulfill its obligations (i.e. nonpayment risk). The nonperformance 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 variable annuity reinsurance liabilities to be paid by the Company and (b) the variable annuity reinsurance assets to be paid by the reinsurers, after considering collateral. The Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy described in Note 13 to the Consolidated Financial Statements because assumptions related to future annuitant behavior are largely unobservable. As discussed further in Note 11 to the Consolidated Financial Statements, due to the reinsurance agreements covering these liabilities, the liabilities do not generally impact net income except for the change in nonperformance risk on the reinsurance recoverable, which is reported in benefit expenses and does not offset the nonperformance risk valuation on the liability. Variable annuity liabilities are established using capital market assumptions and assumptions related to future annuitant behavior (including mortality, lapse and annuity election rates).
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 11 to the Consolidated Financial Statements for additional information on 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.
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.
Variable annuity contracts are accounted for as assumed and ceded reinsurance and categorized as market risk benefits as discussed in Note 10 to the Consolidated Financial Statements.
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 13 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. Prior to the adoption of LDTI on January 1, 2023, net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business was reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive loss. See Note 16 for impact to 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 14 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, 2023 and 2022 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 and certain 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 14 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. With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business. Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.
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.
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 13. 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 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 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, 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.
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, 2023 or December 31, 2022. The nature and use of these derivative financial instruments are described in Note 12.
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. Additionally, as discussed in Note 10E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.
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.
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, net of tax in the tables above are reflected in Net unrealized appreciation (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 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.
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. The separate account activity for the year ended December 31, 2023 and 2022 was primarily driven by changes in the market values of the underlying separate account investments.
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 190 limited partnerships that have a carrying value of $2.9 billion as of December 31, 2023 reported in other long-term investments. 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 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 13 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. All domestic equity securities and international equity funds within pension assets are classified as 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 13 for additional disclosures related to these assets invested in the separate accounts of the Company's subsidiary. Certain securities as described in Note 13, 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. Following a change in reporting units or held for sale determination, goodwill is allocated using relative fair value. 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, trademarks and provider networks. 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 and internally developed software, three to five 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 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, 2023, we had approximately $218 million in deferred tax assets ("DTAs") associated with unrealized investment losses that are partially 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 carry back losses and our ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any valuation allowance in the future. As of December 31, 2023, we had approximately $1.8 billion in DTAs associated with the foreign tax attributes as discussed above. We have determined that approximately $772 million valuation allowance against these DTAs is required based on the Company's taxable income projections and the requirement to utilize the assets within certain time periods. Additionally, the Company has $584 million of deferred tax assets and a full valuation allowance associated with the HCSC transaction, as discussed above. 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, 2023 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 laws or regulations 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 stated dollar amount or 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 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.
Segment Information Intersegment revenues primarily reflect pharmacy and care services 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.
v3.24.0.1
Receivables, Loans, Notes Receivable, and Others (Policies)
 12 Months Ended
Dec. 31, 2023
Receivables [Abstract]  
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 estimated based on the Company's best information available at the time revenue is recognized.
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 Company entered into an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institutionThe transactions under the Facility are accounted for as a sale and recorded as a reduction to accounts receivable in the Consolidated Balance Sheets because control of, and risk related to, the accounts receivable are transferred to the financial institutionAmounts associated with this Facility are reflected within Net cash provided by operating activities in the Consolidated Statements of Cash Flows. Factoring fees paid under this Facility are reflected in Interest expense and other in the Consolidated Statements of Income.As of December 31, 2023, all sold accounts receivable have been collected from manufacturers, $515 million of which have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.
v3.24.0.1
Investments, Debt and Equity Securities (Policies)
 12 Months Ended
Dec. 31, 2023
Investments, Debt and Equity Securities [Abstract]  
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 13 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. Prior to the adoption of LDTI on January 1, 2023, net unrealized appreciation on debt securities supporting the Company's run-off settlement annuity business was reported in Non-current insurance and contractholder liabilities rather than Accumulated other comprehensive loss. See Note 16 for impact to 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 14 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, 2023 and 2022 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 and certain 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 14 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. With the adoption of amended accounting guidance for long-duration insurance contracts on January 1, 2023 (discussed in Note 2 to the Consolidated Financial Statements), realized investment gains and losses no longer exclude amounts that were previously required to adjust future policy benefits for the run-off settlement annuity business. Prior period net realized investment losses have been updated to reflect the impact of adopting LDTI.
v3.24.0.1
Accounts Receivable, Net (Tables)
 12 Months Ended
Dec. 31, 2023
Receivables [Abstract]  
Accounts Receivable, Net
The following amounts were included within Accounts receivable, net:
(In millions)December 31, 2023December 31, 2022
Pharmaceutical manufacturers receivables$8,169 $7,108 
Noninsurance customer receivables8,044 6,899 
Insurance customer receivables2,359 2,963 
Other receivables272 248 
Total$18,844 
Accounts receivable, net classified as assets of businesses held for sale
(1,122)
Total$17,722 $17,218 
v3.24.0.1
Assets and Liabilities of Businesses Held for Sale (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2023
Cash and cash equivalents$467 
Investments1,438 
Accounts receivable, net1,122 
Other assets, including Goodwill (1)
2,963 
Total assets of businesses held for sale5,990 
Insurance and contractholder liabilities1,636 
All other liabilities1,059 
Total liabilities of businesses held for sale$2,695 
(1) Includes Goodwill of $396 million.
v3.24.0.1
Earnings Per Share (Tables)
 12 Months Ended
Dec. 31, 2023
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,
202320222021
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution		DilutedBasicEffect of
Dilution		DilutedBasicEffect of
Dilution		Diluted
Shareholders' net income$5,164 $5,164 $6,704 $6,704 $5,370 $5,370 
Shares:
Weighted average293,892 293,892 309,546 309,546 337,962 337,962 
Common stock equivalents2,990 2,990 3,519 3,519 3,004 3,004 
Total shares293,892 2,990 296,882 309,546 3,519 313,065 337,962 3,004 340,966 
Earnings per share$17.57 $(0.18)$17.39 $21.66 $(0.25)$21.41 $15.89 $(0.14)$15.75 

Amounts reflected above for the years ended December 31, 2022 and 2021 have been restated to reflect the impact of adopting amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements).
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)202320222021
Anti-dilutive options0.9 1.0 1.5 
v3.24.0.1
Debt (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2023December 31, 2022
Short-term debt
Commercial paper$1,237 $— 
$17 million, 8.300% Notes due January 2023
— 17 
$63 million, 7.650% Notes due March 2023
— 63 
$700 million, Floating Rate Notes due July 2023
— 700 
$1,000 million, 3.000% Notes due July 2023
— 994 
$1,187 million, 3.750% Notes due July 2023
— 1,186 
$500 million, 0.613% Notes due March 2024
500 — 
$1,000 million, 3.500% Notes due June 2024 (1)
996 — 
Other, including finance leases42 33 
Total short-term debt$2,775 $2,993 
Long-term debt
$500 million, 0.613% Notes due March 2024
$— $499 
$1,000 million, 3.500% Notes due June 2024
— 990 
$900 million, 3.250% Notes due April 2025 (2)
882 872 
$2,200 million, 4.125% Notes due November 2025 (1)
2,197 2,195 
$1,500 million, 4.500% Notes due February 2026 (1)
1,502 1,503 
$800 million, 1.250% Notes due March 2026 (1)
798 797 
$700 million, 5.685% Notes due March 2026
698 — 
$1,500 million, 3.400% Notes due March 2027
1,450 1,436 
$259 million, 7.875% Debentures due May 2027
259 259 
$600 million, 3.050% Notes due October 2027 (1)
597 597 
$3,800 million, 4.375% Notes due October 2028
3,787 3,785 
$1,500 million, 2.400% Notes due March 2030 (1)
1,493 1,492 
$1,500 million, 2.375% Notes due March 2031 (2)
1,397 1,380 
$45 million, 8.080% Step Down Notes due January 2033 (3)
45 45 
$800 million, 5.400% Notes due March 2033
794 — 
$190 million, 6.150% Notes due November 2036
190 190 
$2,200 million, 4.800% Notes due August 2038
2,193 2,192 
$750 million, 3.200% Notes due March 2040
744 743 
$121 million, 5.875% Notes due March 2041
119 119 
$448 million, 6.125% Notes due November 2041
487 488 
$317 million, 5.375% Notes due February 2042
315 315 
$1,500 million, 4.800% Notes due July 2046
1,467 1,466 
$1,000 million, 3.875% Notes due October 2047
989 989 
$3,000 million, 4.900% Notes due December 2048
2,970 2,968 
$1,250 million, 3.400% Notes due March 2050
1,237 1,236 
$1,500 million, 3.400% Notes due March 2051
1,479 1,478 
Other, including finance leases66 66 
Total long-term debt$28,155 $28,100 
(1)Included in the February 2024 debt tender offers discussed below.
(2)The Company has entered into interest rate swap contracts hedging a portion of these fixed-rate debt instruments. See Note 12 to the Consolidated Financial Statements for further information about the Company's interest rate risk management and these derivative instruments.
(3)Interest rate step down to 8.080% effective January 15, 2023.
Summary of Debt Issuances
On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance were used for general corporate purposes, and included repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

PrincipalMaturity DateInterest RateNet Proceeds
$700 million (1)
March 15, 20265.685%$698 million
$800 million (2)
March 15, 20335.400%$796 million
(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.
(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.
Maturities of Outstanding Long-Term Debt Maturities of outstanding long-term debt as of December 31, 2023 are as follows and exclude the impact of the 2024 debt issuance and debt tender offers described above:
(In millions)
Scheduled Maturities (1)
2024$1,500 
2025$3,100 
2026$3,000 
2027$2,359 
2028$3,800 
Maturities after 2028$16,122 
(1) Long-term debt maturity amounts include current maturities of long-term debt. Finance leases are excluded from this table. See Note 21 - Leases for finance lease maturity amounts.
v3.24.0.1
Common and Preferred Stock (Tables)
 12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Share Activity
The following table presents the share activity of The Cigna Group:
For the Years Ended December 31,
(Shares in thousands)202320222021
Common: Par value $0.01; 600,000 shares authorized
Outstanding- January 1,298,676 322,948 354,771 
Net issued for stock option exercises and other benefit plans1,619 3,173 3,375 
Repurchased common stock(7,791)(27,445)(35,198)
Outstanding- December 31,292,504 298,676 322,948 
Treasury stock107,390 99,143 71,246 
Issued- December 31,399,894 397,819 394,194 
Dividend Payments
The following table provides details of the Company's dividend payments:
Record DatePayment DateAmount per Share
Total Amount Paid (in millions)
2023
March 8, 2023March 23, 2023$1.23$368
June 7, 2023June 22, 2023$1.23$362
September 6, 2023September 21, 2023$1.23$362
December 6, 2023December 21, 2023$1.23$358
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
v3.24.0.1
Insurance and Contractholder Liabilities (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2023December 31, 2022
(In millions)CurrentNon-currentTotalCurrentNon-currentTotal
Unpaid claims and claim expenses
Cigna Healthcare
$5,017 $75 $5,092 $4,117 $59 $4,176 
Other Operations99 154 253 107 177 284 
Future policy benefits
Cigna Healthcare
97 518 615 43 544 587 
Other Operations163 3,375 3,538 150 3,442 3,592 
Contractholder deposit funds
Cigna Healthcare
12 133 145 14 157 171 
Other Operations362 6,178 6,540 351 6,358 6,709 
Market risk benefits37 966 1,003 51 1,217 1,268 
Unearned premiums846 22 868 576 22 598 
Total6,633 11,421 18,054 
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)
(1,119)(517)(1,636)
Total insurance and contractholder liabilities$5,514 $10,904 $16,418 $5,409 $11,976 $17,385 
(1) Amounts classified as liabilities of businesses held for sale include $823 million of Unpaid claims, $429 million of Future policy benefits, $261 million of Unearned premiums and $123 million of Contractholder deposit funds as of December 31, 2023.
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)202320222021
Beginning balance$4,176 $4,261 $3,695 
Less: Reinsurance and other amounts recoverable221 261 237 
Beginning balance, net3,955 4,000 3,458 
Incurred costs related to:
Current year35,953 31,342 31,755 
Prior years(279)(259)(219)
Total incurred35,674 31,083 31,536 
Paid costs related to:
Current year31,322 27,583 27,929 
Prior years3,451 3,545 3,065 
Total paid34,773 31,128 30,994 
Ending balance, net4,856 3,955 4,000 
Add: Reinsurance and other amounts recoverable236 221 261 
Ending balance (1)
$5,092 $4,176 $4,261 
(1) Includes $823 million classified as liabilities of businesses held for sale as of December 31, 2023.
Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
For the Years Ended December 31,
20232022
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors$70 0.2 %$62 0.2 %
Medical cost trend209 0.7 197 0.6 
Total favorable variance$279 0.9 %$259 0.8 %
(1)Percentage of current year incurred costs as reported for the year ended December 31, 2022.
(2)Percentage of current year incurred costs as reported for the year ended December 31, 2021.
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, 2023 (net of reinsurance) reported in the Cigna Healthcare segment. The information about incurred and paid claims development for the year ended December 31, 2022 is presented as supplementary information and is unaudited.
 Incurred Costs 
Incurral Year2022
(Unaudited)		2023Unpaid Claims & Claim Expenses
(In millions)  
2022$30,309 $30,050 209 
202334,878 4,498 
Cumulative incurred costs for the periods presented$64,928  
 Cumulative Costs Paid 
Incurral Year2022
(Unaudited)		2023 
(In millions)
2022$26,687 $29,841  
202330,380  
Cumulative paid costs for the periods presented$60,221  
Outstanding liabilities for the periods presented, net of reinsurance$4,707  
Other long-duration liabilities not included in development table above149  
Net unpaid claims and claims expenses - Cigna Healthcare
4,856  
Reinsurance and other amounts recoverable236  
Unpaid claims and claim expenses - Cigna Healthcare
$5,092  
Future Policy Benefit Activity
The weighted average interest rates applied and duration for future policy benefits in the Cigna Healthcare segment, consisting primarily of supplemental health products including individual Medicare supplement, limited benefit health products and individual private medical insurance, were as follows:
As of
December 31, 2023December 31, 2022
Interest accretion rate 2.54 %2.58 %
Current discount rate 4.92 %5.57 %
Weighted average duration 7.9 years7.7 years
The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment are as follows:
For the Years Ended December 31,
(In millions)20232022
Present value of expected net premiums
Beginning balance$8,557 $9,314 
Reversal of effect of beginning of period discount rate assumptions1,537 (367)
Effect of assumption changes and actual variances from expected experience (1)
314 1,286 
Issuances and lapses 1,255 1,067 
Net premiums collected(1,370)(1,280)
Interest and other (2)
94 74 
Ending balance at original discount rate10,387 10,094 
Effect of end of period discount rate assumptions(1,154)(1,537)
Ending balance (3)
$9,233 $8,557 
Present value of expected policy benefits
Beginning balance$8,945 $9,794 
Reversal of effect of discount rate assumptions1,611 (379)
Effect of assumption changes and actual variances from expected experience (1)
112 1,148 
Issuances and lapses 1,309 1,176 
Benefit payments(1,374)(1,401)
Interest and other (2)
250 218 
Ending balance at original discount rate10,853 10,556 
Effect of discount rate assumptions(1,220)(1,611)
Ending balance (4)
$9,633 $8,945 
Liability for future policy benefits $400 $388 
Other (5)
215 199 
Total liability for future policy benefits (6)(7)
$615 $587 
(1)Includes the effect of actual variances from expectations, which (decreased)/increased the total liability for future policy benefits by $(12) million and $46 million, respectively, for the years ended December 31, 2023 and December 31, 2022.
(2)Includes the foreign exchange rate impact of translating from transactional and functional currency to United States dollar and the impact of flooring the liability at zero. The flooring impact is calculated at the cohort level after discounting the reserves at the current discount rate.
(3)As of December 31, 2023 and December 31, 2022 undiscounted expected future gross premiums were $18.7 billion and $17.5 billion, respectively. As of December 31, 2023 and December 31, 2022 discounted expected future gross premiums were $13.5 billion and $12.2 billion, respectively.
(4)As of December 31, 2023 and December 31, 2022, undiscounted expected future policy benefits were $13.3 billion and $12.7 billion, respectively.
(5)The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off.
(6)$72 million and $155 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of December 31, 2023 and December 31, 2022, respectively, relate to the liability for future policy benefits. Additionally, $79 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of December 31, 2023.
(7)Includes $429 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of December 31, 2023.
The weighted average interest rates applied and duration for future policy benefits in Other Operations, consisting of annuity and life insurance products, were as follows:
As of
December 31, 2023December 31, 2022
Interest accretion rate 5.64 %5.64 %
Current discount rate 4.87 %5.19 %
Weighted average duration 11.4 years11.5 years
Summary of Market Risk Benefit
Market risk benefits activity was as follows:
For the Years Ended December 31,
(Dollars in millions)20232022
Balance, beginning of year$1,268 $1,824 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,379 1,949 
Changes due to expected run-off(19)(54)
Changes due to capital markets versus expected(254)(567)
Changes due to policyholder behavior versus expected(5)(14)
Assumption changes(16)65 
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)1,085 1,379 
Nonperformance risk (own credit risk), end of period(82)(111)
Balance, end of period$1,003 $1,268 
Reinsured market risk benefit, end of period$1,081 $1,374 
(In millions)
Reinsurer (1)
December 31, 2023December 31, 2022
Collateral and Other Terms
at December 31, 2023
Berkshire$873 $1,116 
95% were secured by assets in a trust.
Sun Life Assurance Company of Canada92 115 
Liberty Re (Bermuda) Ltd.104 128 
100% were secured by assets in a trust.
SCOR SE31 39 
80% were secured by a letter of credit.
Market risk benefits (2)
$1,100 $1,398 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes IBNR and outstanding claims of $19 million. These amounts are excluded from market risk benefits at December 31, 2023 in Note 10 and Note 11A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.
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, average attained age of contractholders (weighted by exposure) and the number of contractholders for guarantees assumed by the Company. The net amount at risk is the amount that the Company would have to pay to contractholders if all deaths or annuitizations occurred as of the earliest possible date in accordance with the insurance contract. As of December 31, 2023, the account value increased primarily due to favorable equity market performance, which resulted in an decrease 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, 2023December 31, 2022
Account value$7,736 $7,436 
Net amount at risk$1,609 $2,494 
Average attained age of contractholders (weighted by exposure)77.3 years74.7 years
Number of contractholders (estimated)140,000 150,000 
v3.24.0.1
Reinsurance (Tables)
 12 Months Ended
Dec. 31, 2023
Reinsurance Disclosures [Abstract]  
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level
The Company's reinsurance recoverables as of December 31, 2023 are presented at amount due by range of external credit rating and collateral level in the following table, with reinsurance recoverables that are market risk benefits separately presented at fair value:
(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 (2)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (1)
$— $— $90 $90 
BBB- to BBB+ equivalent current credit ratings (1)
— — 59 59 
Not rated151 5 182 338 
Total recoverables related to ongoing operations151 5 331 487 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (1)
Lincoln National Life and Lincoln Life & Annuity of New York— 2,656 — 2,656 
Empower Annuity Insurance Company— — 130 130 
Prudential Insurance Company of America341 — — 341 
Life Insurance Company of North America— 356 — 356 
Other166 19 14 199 
Not rated— 7 4 11 
Total recoverables related to acquisition, disposition or run-off activities507 3,038 148 3,693 
Total reinsurance recoverables before market risk benefits$658 $3,043 $479 $4,180 
Allowance for uncollectible reinsurance(35)
Market risk benefits (3)
1,081 
Total reinsurance recoverables (4)
$5,226 
(1)Certified by a NRSRO.
(2)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
(3)Prior to the adoption of LDTI, "acquisition, disposition or run-off activities" in the table above included Berkshire and certain Other recoverables that are related to the Company's variable annuity reinsurance products discussed in section B below. These amounts are now reported at fair market value as MRBs, as further discussed in Note 10 to the Consolidated Financial Statements. At December 31, 2022, we reported $711 million of recoverables related to the GMDB variable annuity reinsurance product. The restated December 31, 2022 variable annuity reinsurance recoverable balance is $1.4 billion, which also includes the GMIB variable annuity reinsurance product that was classified in Other assets prior to the adoption of LDTI.
(4)Includes $183 million of current reinsurance recoverables that are reported in Other current assets and $208 million of reinsurance recoverables classified as assets of businesses held for sale.
Effects of Reinsurance
The following table presents direct, assumed and ceded earned 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)202320222021
Premiums
Short-duration contracts
Direct$42,266 $36,747 $36,513 
Assumed303 416 335 
Ceded(277)(265)(148)
Total short-duration contract premiums(1)
42,292 36,898 36,700 
Long-duration contracts
Direct2,084 3,219 4,753 
Assumed72 85 99 
Ceded(211)(286)(398)
Total long-duration contract premiums1,945 3,018 4,454 
Total premiums$44,237 $39,916 $41,154 
Total reinsurance recoveries$456 $702 $552 
(1) Total short-duration contracts written premiums were $41.1 billion, $35.0 billion and $35.6 billion for 2023, 2022 and 2021, respectively.
Reinsurance Recoverables for Variable Annuity Business
Market risk benefits activity was as follows:
For the Years Ended December 31,
(Dollars in millions)20232022
Balance, beginning of year$1,268 $1,824 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,379 1,949 
Changes due to expected run-off(19)(54)
Changes due to capital markets versus expected(254)(567)
Changes due to policyholder behavior versus expected(5)(14)
Assumption changes(16)65 
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)1,085 1,379 
Nonperformance risk (own credit risk), end of period(82)(111)
Balance, end of period$1,003 $1,268 
Reinsured market risk benefit, end of period$1,081 $1,374 
(In millions)
Reinsurer (1)
December 31, 2023December 31, 2022
Collateral and Other Terms
at December 31, 2023
Berkshire$873 $1,116 
95% were secured by assets in a trust.
Sun Life Assurance Company of Canada92 115 
Liberty Re (Bermuda) Ltd.104 128 
100% were secured by assets in a trust.
SCOR SE31 39 
80% were secured by a letter of credit.
Market risk benefits (2)
$1,100 $1,398 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes IBNR and outstanding claims of $19 million. These amounts are excluded from market risk benefits at December 31, 2023 in Note 10 and Note 11A to the Consolidated Financial Statements. At December 31, 2022, IBNR and outstanding claims of $27 million offset by premium due of $3 million were excluded from the market risk benefits as restated due to the adoption of LDTI.
v3.24.0.1
Investments (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2023December 31, 2022
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$590 $9,265 $9,855 $654 $9,218 $9,872 
Equity securities31 3,331 3,362 45 577 622 
Commercial mortgage loans182 1,351 1,533 67 1,547 1,614 
Policy loans— 1,211 1,211 — 1,218 1,218 
Other long-term investments— 4,181 4,181 — 3,728 3,728 
Short-term investments206 — 206 139 — 139 
Total$1,009 $19,339 $20,348 
Investments classified as assets of businesses held for sale (1)
(84)(1,354)(1,438)
Investments per Consolidated Balance Sheets$925 $17,985 $18,910 $905 $16,288 $17,193 
(1) Investments related to the HCSC transaction that were held for sale as of December 31, 2023. These investments were primarily comprised of debt securities and commercial mortgage loans, and to a lesser extent, other long term investments.
Debt Securities by Contractual Maturity
The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of December 31, 2023:
(In millions)Amortized
Cost		Fair
Value
Due in one year or less$622 $605 
Due after one year through five years3,914 3,761 
Due after five years through ten years3,194 3,005 
Due after ten years2,251 2,119 
Mortgage and other asset-backed securities398 365 
Total$10,379 $9,855 
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, 2023
Federal government and agency$251 $— $24 $(8)$267 
State and local government37 — 2 (1)38 
Foreign government355 — 10 (13)352 
Corporate9,338 (33)158 (630)8,833 
Mortgage and other asset-backed398 — 1 (34)365 
Total$10,379 $(33)$195 $(686)$9,855 
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 
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, 2023December 31, 2022
(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$330 $338 $(8)142$5,533 $6,127 $(594)1,659 
Below investment grade161 170 (9)135887 964 (77)1,287 
More than one year
Investment grade5,441 6,036 (595)1,5901,151 1,487 (336)462 
Below investment grade701 775 (74)486330 382 (52)369 
Total$6,633 $7,319 $(686)2,353 $7,901 $8,960 $(1,059)3,777 
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, 2023 or 2022.
December 31, 2023 December 31, 2022
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$656 $51 $673 $138 
Equity securities with no readily determinable fair value3,248 3,311 380 484 
Total$3,904 $3,362 $1,053 $622 
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, 2023December 31, 2022
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$802 2.13$901 2.12
60% to 79%574 1.77564 1.73
80% to 100%157 0.65149 1.17
Total$1,533 1.8264 %$1,614 1.8960 %
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 25% of the committed amounts in 2024.
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 $253 million in 2023, $487 million in 2022 and $568 million in 2021.
Unfunded Commitments as of
Carrying Value as of December 31,
(In millions)20232022December 31, 2023
Real estate investments$1,606 $1,319 $712 
Securities partnerships2,400 2,166 2,085 
Other175 243 — 
Total$4,181 $3,728 $2,797 
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, 2023December 31, 2022
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
$1,026 $1,083 
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 $1,500 
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
$415 $460 
Components of Net Investment Income
The components of Net investment income were as follows:
For the Years Ended December 31,
(In millions)202320222021
Debt securities$500 $572 $689 
Equity securities123 14 12 
Commercial mortgage loans65 59 60 
Policy loans60 59 63 
Other long-term investments123 390 758 
Short-term investments and cash339 115 26 
Total investment income1,210 1,209 1,608 
Less investment expenses44 54 59 
Net investment income$1,166 $1,155 $1,549 
Realized Gains and Losses on Investments
The following realized gains and losses on investments exclude 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)202320222021
Net realized investment (losses) gains, excluding credit loss expense and asset write-downs
$(68)$(451)$196 
Credit (loss) / recovery and other investment write-down (losses)(10)(36)2 
Net realized investment (losses) gains, before income taxes
$(78)$(487)$198 
v3.24.0.1
Fair Value Measurements (Tables)
 12 Months Ended
Dec. 31, 2023
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. Further information regarding insurance assets and liabilities carried at fair value is provided in Note 10E to the Consolidated Financial Statements. 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, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022
Financial assets at fair value
Debt securities
Federal government and agency$130 $147 $137 $165 $— $— $267 $312 
State and local government— — 38 41 — — 38 41 
Foreign government— — 352 365 — — 352 365 
Corporate
— — 8,432 8,394 401 412 8,833 8,806 
Mortgage and other asset-backed— — 319 313 46 35 365 348 
Total debt securities130 147 9,278 9,278 447 447 9,855 9,872 
Equity securities (1)
4 6 47 132 — — 51 138 
Short-term investments— — 206 139 — — 206 139 
Derivative assets— — 131 230 1 1 132 231 
Financial liabilities at fair value
Derivative liabilities$— $— $4 $— $— $— $4 $— 
(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 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, 2023December 31, 2022Unobservable Input December 31, 2023December 31, 2023December 31, 2022
Debt securities
Corporate$401 $412 Liquidity
70 - 1235 (310)
bps
60 - 1060 (270)
bps
Mortgage and other asset-backed securities46 35 Liquidity
95 - 640 (310)
bps
105 - 520 (310)
bps
Total Level 3 debt securities$447 $447 
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)20232022
Debt and Equity Securities
Beginning balance$447 $796 
(Losses) gains included in Shareholders' net income
(2)11 
Gains (losses) included in Other comprehensive loss
8 (59)
Purchases, sales and settlements
Purchases10 158 
Settlements(52)(207)
Total purchases, sales and settlements(42)(49)
Transfers into/(out of) Level 3
Transfers into Level 395 124 
Transfers out of Level 3(59)(376)
Total transfers into/(out of) Level 336 (252)
Ending balance$447 $447 
Total losses included in Shareholders' net income attributable to instruments held at the reporting date
$(2)$(2)
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period
$3 $(60)
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, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022December 31, 2023December 31, 2022
Guaranteed separate accounts (See Note 24)
$226 $203 $352 $382 $— $— $578 $585 
Non-guaranteed separate accounts (1)
158 211 5,797 5,522 217 203 6,172 5,936 
Subtotal$384 $414 $6,149 $5,904 $217 $203 6,750 6,521 
Non-guaranteed separate accounts priced at NAV as a practical expedient (1)
680 757 
Total$7,430 $7,278 
(1)Non-guaranteed separate accounts include $4.0 billion as of December 31, 2023 and December 31, 2022 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of December 31, 2023 and December 31, 2022.
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, 2023Redemption Frequency
(if currently eligible)		Redemption Notice
Period
(In millions)December 31, 2023December 31, 2022
Securities partnerships$419 $451 $254 Not applicableNot applicable
Real estate funds258 302 — Quarterly
30 - 90 days
Hedge funds3 4 — Up to annually, varying by fund
30 - 90 days
Total$680 $757 $254 
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, 2023December 31, 2022
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,430 $1,533 $1,491 $1,614 
Long-term debt, including current maturities, excluding finance leasesLevel 2$28,033 $29,585 $28,653 $30,994 
v3.24.0.1
Collectively Significant Operating Unconsolidated Subsidiaries (Tables)
 12 Months Ended
Dec. 31, 2023
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. Prior period operating joint venture amounts have been retrospectively restated to reflect the adoption of amended accounting guidance for long-duration insurance contracts, as discussed in Note 2 to the Consolidated Financial Statements.
For the Years Ended December 31,
(In millions)202320222021
Revenues$5,962 $4,665 $3,750 
Net income (loss)$98 $(12)$180 
(In millions)December 31, 2023December 31, 2022
Total assets$26,681 $21,026 
Total liabilities$25,534 $19,462 
v3.24.0.1
Accumulated Other Comprehensive Income (Loss) (Tables)
 12 Months Ended
Dec. 31, 2023
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Changes in the Components of AOCI
Changes in the components of AOCI, including the restatement for amended accounting guidance for long-duration insurance contracts (discussed in Note 2 to the Consolidated Financial Statements), are as follows:
For the Years Ended December 31,
(In millions)202320222021
Securities and Derivatives
Beginning balance, as previously disclosed$900 
Cumulative effect of accounting for Long-duration Insurance Contracts guidance (ASU 2018-12)668 
Beginning balance, as retrospectively restated$(332)$1,266 1,568 
Unrealized appreciation (depreciation) on securities and derivatives620 (2,274)(335)
Tax (expense) benefit(146)467 52 
Net unrealized appreciation (depreciation) on securities and derivatives474 (1,807)(283)
Reclassification adjustment for losses included in Shareholders' net income ((Loss) gain on sale of businesses)— 172 — 
Reclassification adjustment for losses (gains) included in Shareholders' net income (Net realized investment (losses) gains)38 47 (24)
Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses)(1)— — 
Reclassification adjustment for tax (benefit) expense included in Shareholders' net income(8)(10)5 
Net losses (gains) reclassified from AOCI to Shareholders' net income29 209 (19)
Other comprehensive income (loss), net of tax503 (1,598)(302)
Ending balance$171 $(332)$1,266 

For the Years Ended December 31,
(In millions)202320222021
Net long-duration insurance and contractholder liabilities measurement adjustments (1)
Beginning balance, as previously disclosed$— 
Cumulative effect of accounting for Long-duration Insurance Contracts guidance (ASU 2018-12)(832)
Beginning balance, as retrospectively restated$(256)$(765)(832)
Current period change in discount rate for certain long-duration liabilities(913)642 59 
Tax benefit (expense)222 (122)(3)
Net current period change in discount rate for certain long-duration liabilities(691)520 56 
Current period change in instrument-specific credit risk for market risk benefits(29)(14)13 
Tax benefit (expense)5 3 (2)
Net current period change in instrument-specific credit risk for market risk benefits(24)(11)11 
Other comprehensive (loss) income, net of tax(715)509 67 
Ending balance$(971)$(256)$(765)
(1)Established upon the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
For the Years Ended December 31,
(In millions)202320222021
Translation of foreign currencies
Beginning balance, as retrospectively restated$(154)$(233)$(15)
Translation of foreign currencies— (277)(213)
Tax benefit (expense)5 (33)(19)
Net translation of foreign currencies5 (310)(232)
Reclassification adjustment for losses included in Net income ((Loss) gain on sale of businesses)— 358 — 
Reclassification adjustment for tax expense included in Net income— 29 — 
Net translation losses reclassified from AOCI to Net income— 387 — 
Translation of foreign currencies— 81 (213)
Tax benefit (expense)5 (4)(19)
Other comprehensive income (loss), net of tax5 77 (232)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests— (2)(14)
Shareholders' other comprehensive income (loss), net of tax5 79 (218)
Ending balance$(149)$(154)$(233)
For the Years Ended December 31,
(In millions)202320222021
Postretirement benefits liability
Beginning balance$(916)$(1,336)$(1,746)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)46 65 85 
Reclassification adjustment for (gains) included in Shareholders' net income ((Loss) gain on sale of businesses)— (1)— 
Reclassification adjustment for settlement (Interest expense and other)— — 4 
Reclassification adjustment for tax (benefit) included in Shareholders' net income(11)(16)(21)
Net adjustments reclassified from AOCI to Shareholders' net income35 48 68 
Valuation update(46)487 448 
Tax benefit (expense)12 (115)(106)
Net change due to valuation update(34)372 342 
Other comprehensive income, net of tax1 420 410 
Ending balance$(915)$(916)$(1,336)

For the Years Ended December 31,
(In millions)202320222021
Total Accumulated other comprehensive loss
Beginning balance, as previously disclosed$(861)
Cumulative effect of accounting for Long-duration Insurance Contracts guidance (ASU 2018-12)(164)
Beginning balance, as retrospectively restated$(1,658)$(1,068)(1,025)
Shareholders' other comprehensive (loss), net of tax(206)(590)(43)
Ending balance$(1,864)$(1,658)$(1,068)
v3.24.0.1
Organizational Efficiency Plan (Tables)
 12 Months Ended
Dec. 31, 2023
Restructuring and Related Activities [Abstract]  
Rollforward of Accrued Liability
The following table summarizes a roll forward of the accrued liability recorded in Accrued expenses and other liabilities:
(In millions) 
Balance, December 31, 2022
$— 
Fourth quarter 2023 charge
232 
2023 payments
(30)
Balance, December 31, 2023
$202 
v3.24.0.1
Pension (Tables)
 12 Months Ended
Dec. 31, 2023
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)20232022
Change in benefit obligation
Benefit obligation, January 1$3,948 $5,223 
Service cost1 2 
Interest cost204 140 
Actuarial losses (gains), net (1)
93 (1,094)
Benefits paid from plan assets(294)(296)
Other
(18)(27)
Benefit obligation, December 313,934 3,948 
Change in plan assets
Fair value of plan assets, January 14,186 4,846 
Actual return on plan assets246 (366)
Benefits paid(294)(296)
Contributions— 2 
Fair value of plan assets, December 314,138 4,186 
Funded status$204 $238 
Amounts presented in Consolidated Balance Sheets
Other assets
$204 $238 
(1) 2023 losses reflect a decrease in the discount rate while 2022 gains reflect an increase in the discount rate.
Benefit Payments The following benefit payments are expected to be paid in:
(In millions)
2024$319 
2025$316 
2026$317 
2027$314 
2028$311 
2029 - 2033$1,484 
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, 2023December 31, 2022
Unrecognized net (losses)
$(1,207)$(1,208)
Unrecognized prior service cost(4)(5)
Postretirement benefits liability adjustment$(1,211)$(1,213)
Components of Net Pension Cost
Net pension cost was as follows:
For the Years Ended December 31,
(In millions)202320222021
Service cost$1 $2 $2 
Interest cost204 140 132 
Expected long-term return on plan assets(204)(272)(269)
Amortization of:
Prior actuarial losses, net52 89 78 
Settlement loss— — 4 
Net (benefit) cost$53 $(41)$(53)
Assumptions Used for Pension
For the Years Ended December 31,
 20232022
Discount rate:
Pension benefit obligation5.10%5.43%
Pension benefit cost5.43%2.82%
Expected long-term return on plan assets:
Pension benefit cost6.50%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, 2023December 31, 2022
Debt securities:
Federal government and agency$12 $11 
Corporate2,780 2,349 
Asset-backed121 109 
Fund investments278 478 
Total debt securities3,191 2,947 
Equity securities:
Domestic27 89 
International, including funds and pooled separate accounts (1)
6 35 
Total equity securities33 124 
Securities partnerships419 452 
Real estate funds, including pooled separate accounts (1)
270 315 
Commercial mortgage loans46 63 
Guaranteed deposit account contract48 50 
Cash equivalents and other current assets, net131 235 
Total pension assets at fair value$4,138 $4,186 
(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)202320222021
Expense$296 $274 $268 
v3.24.0.1
Employee Incentive Plans (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2023December 31, 2022December 31, 2021
Common shares available for award14.4 16.6 19.1 
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:
 202320222021
Dividend yield1.58 %1.98 %1.85 %
Expected volatility30.0 %30.0 %30.0 %
Risk-free interest rate3.6 %1.6 %0.5 %
Expected option life4.7 years4.5 years4.5 years
Weighted average fair value of options$79.66 $50.61 $44.84 
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,
202320222021
(Options in thousands)OptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise PriceOptionsWeighted Average Exercise Price
Outstanding - January 16,992 $186.54 8,490 $169.47 9,742 $152.40 
Granted915 $294.37 1,375 $226.95 1,524 $213.81 
Exercised(1,080)$174.66 (2,617)$149.97 (2,584)$129.08 
Expired or canceled(131)$246.95 (256)$211.22 (192)$199.10 
Outstanding - December 316,696 $202.02 6,992 $186.54 8,490 $169.47 
Options exercisable at year-end4,616 $179.28 4,410 $168.97 5,612 $152.92 
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)202320222021
Intrinsic value of options exercised$126 $313 $268 
Cash received for options exercised$187 $389 $326 
Tax benefit from options exercised$17 $47 $50 
The following table summarizes information for outstanding common stock options:
December 31, 2023
 Options
Outstanding		Options
Exercisable
Number (in thousands)6,696 4,616 
Total intrinsic value (in millions)$652 $555 
Weighted average exercise price$202.02 $179.28 
Weighted average remaining contractual life5.9 years4.7 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,
202320222021
(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 11,535 $219.25 1,524 $202.85 1,600 $186.12 
Awarded700 $294.60 876 $229.60 899 $213.82 
Vested(759)$214.70 (714)$197.83 (866)$184.07 
Forfeited(72)$256.24 (151)$215.02 (109)$197.01 
Outstanding - December 311,404 $257.38 1,535 $219.25 1,524 $202.85 
The fair value of vested restricted stock at the vesting date was as follows:
For the Years Ended December 31,
(In millions)202320222021
Fair value of vested restricted stock$220 $167 $183 
Status of and Changes in SPSs
The following table shows the status of, and changes in, SPSs:
For the Years Ended December 31,
 202320222021
(Awards in thousands)SharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award DateSharesWeighted Average Fair Value at Award Date
Outstanding - January 1780 $212.68 860 $197.07 808 $190.02 
Awarded219 $293.85 294 $230.69 331 $213.90 
Vested(250)$191.78 (261)$183.60 (206)$196.29 
Forfeited(63)$237.50 (113)$207.75 (73)$197.38 
Outstanding - December 31686 $243.90 780 $212.68 860 $197.07 
The fair value of vested SPSs at the vesting date was as follows:
For the Years Ended December 31,
 202320222021
(Shares in thousands; $ in millions)SharesFair ValueSharesFair ValueSharesFair Value
Shares of The Cigna Group common stock distributed upon SPS vesting257 $76 137 $31 243 $51 
Compensation Cost and Tax Effects of Share-based Compensation 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 income tax expense when stock options are exercised, or when restricted stock and SPSs vest.
For the Years Ended December 31,
(In millions)202320222021
Total compensation cost for shared-based awards$286 $264 $268 
Tax benefits recognized$92 $80 $73 
v3.24.0.1
Goodwill, Other Intangibles and Property and Equipment (Tables)
 12 Months Ended
Dec. 31, 2023
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, 2022 (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 
Goodwill transferred to assets of businesses held for sale— (1,553)— (1,553)
Impact of foreign currency translation and other adjustments— 1 — 1 
Goodwill at December 31, 2023
$35,130 $9,129 $— $44,259 
(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, 2023   
Customer relationships$29,978 $7,645 $22,333 
Trade Name - Express Scripts8,400 8,400 
Other317 110 207 
Other intangible assets38,695 7,755 30,940 
Value of business acquired ("VOBA" reported in Other assets)
211 142 69 
Total (1)
$38,906 $7,897 $31,009 
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 (reported in Other assets)
210 133 77 
Total$38,932 $6,363 $32,569 
(1) Includes $69 million of VOBA and $77 million of Other 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, 2023   
Customer relationships$29,978 $7,645 $22,333 
Trade Name - Express Scripts8,400 8,400 
Other317 110 207 
Other intangible assets38,695 7,755 30,940 
Value of business acquired ("VOBA" reported in Other assets)
211 142 69 
Total (1)
$38,906 $7,897 $31,009 
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 (reported in Other assets)
210 133 77 
Total$38,932 $6,363 $32,569 
(1) Includes $69 million of VOBA and $77 million of Other 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, 2023   
Internal-use software$10,155 $7,161 $2,994 
Other property and equipment2,282 1,405 877 
Total property and equipment (1)
$12,437 $8,566 $3,871 
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 
(1) Includes $176 million of Property and equipment net carrying value classified as assets of businesses held for sale.
Components of Depreciation and Amortization Expense Depreciation and amortization expense was comprised of the following:
For the Years Ended December 31,
(In millions)202320222021
Internal-use software$1,216 $1,068 $1,097 
Other property and equipment260 251 253 
Value of business acquired (reported in Other assets)
7 12 25 
Other intangibles1,552 1,606 1,548 
Total depreciation and amortization$3,035 $2,937 $2,923 
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
2024$2,892 
2025$2,357 
2026$1,803 
2027$1,559 
2028$1,484 
v3.24.0.1
Leases (Tables)
 12 Months Ended
Dec. 31, 2023
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 ROU assets and lease liabilities were as follows:
(In millions)December 31, 2023December 31, 2022
Operating leases:
Operating lease ROU assets in Other assets
$370 $375 
Accrued expenses and other liabilities$105 $114 
Other non-current liabilities340 346 
Total operating lease liabilities$445 $460 
Finance leases:
Property and equipment, gross$177 $145 
Accumulated depreciation(73)(48)
Property and equipment, net$104 $97 
Short-term debt$42 $33 
Long-term debt66 66 
Total finance lease liabilities$108 $99 
Components of Lease Expense
The components of lease expense were as follows:
For the Years Ended December 31,
(In millions)202320222021
Operating lease cost$115 $124 $170 
Finance lease cost:
Amortization of ROU assets41 33 22 
Interest on lease liabilities4 2 2 
Total finance lease cost45 35 24 
Variable lease cost38 41 39 
Total lease cost$198 $200 $233 
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)202320222021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash outflows from operating leases$132 $148 $167 
Operating cash outflows from finance leases$4 $2 $2 
Financing cash outflows from finance leases$39 $33 $22 
 
ROU assets obtained in exchange for lease obligations:
Operating leases$103 $43 $122 
Finance leases$48 $84 $20 
Maturities of Operating Lease Liabilities
Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2024$110 $46 
2025102 38 
202683 19 
202763 6 
202841 6 
Thereafter98 — 
Total lease payments497 115 
Less: imputed interest52 7 
Total$445 $108 
Maturities of Finance Lease Liabilities
Maturities of lease liabilities are as follows:
(In millions)Operating LeasesFinance Leases
2024$110 $46 
2025102 38 
202683 19 
202763 6 
202841 6 
Thereafter98 — 
Total lease payments497 115 
Less: imputed interest52 7 
Total$445 $108 
v3.24.0.1
Shareholders Equity and Dividend Restrictions (Tables)
 12 Months Ended
Dec. 31, 2023
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)202320222021
Net income$5.3 $5.7 $3.4 
Surplus$14.9 $16.4 $13.3 
These amounts, including restricted GAAP net assets of the Company's subsidiaries, were as follows:
(In billions)December 31, 2023
Minimum statutory surplus required by regulators (1)
$4.8 
Investments on deposit with regulatory bodies$0.3 
Maximum dividend distributions permitted in 2024 without regulatory approval
$2.1 
Maximum loans to the parent company permitted without regulatory approval$1.4 
Restricted GAAP net assets of The Cigna Group's subsidiaries$12.3 
(1) Excludes amounts associated with foreign operated equity method joint ventures.
v3.24.0.1
Income Taxes (Tables)
 12 Months Ended
Dec. 31, 2023
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)202320222021
Current taxes
U.S. income taxes$1,459 $1,679 $1,267 
Foreign income taxes161 219 207 
State income taxes180 189 112 
Total current taxes1,800 2,087 1,586 
Deferred taxes (benefits)
U.S. income tax benefits
(533)(275)(163)
Foreign income (tax benefits) taxes
(1,046)(28)69 
State income tax benefits
(80)(169)(122)
Total deferred tax benefits
(1,659)(472)(216)
Total income taxes$141 $1,615 $1,370 
Reconciliation of Total Income Taxes to the Amount Computed Using the Nominal Federal Income Tax Rate
Total income taxes were different from the amount computed using the nominal federal income tax rate for the following reasons:
For the Years Ended December 31,
 202320222021
(In millions)$%$%$%
Tax expense at nominal rate$1,158 21.0 %$1,763 21.0 %$1,426 21.0 %
Impact of sale of businesses— — (37)(0.4)— — 
Impact of businesses held for sale(213)(3.9)— — — — 
Effect of foreign earnings(173)(3.1)(96)(1.2)(33)(0.5)
State income tax (benefit), net of federal income tax benefit
(39)(0.7)16 0.2 (9)(0.1)
Swiss tax attributes(1,674)(30.4)— — — — 
Other foreign tax attributes(153)(2.8)— — — — 
Change in valuation allowance1,290 23.4 — — — — 
Other(55)(0.9)(31)(0.4)(14)(0.2)
Total income taxes$141 2.6 %$1,615 19.2 %$1,370 20.2 %
Deferred Income Tax Assets and Liabilities
Deferred income tax assets and liabilities were as follows:
(In millions)December 31, 2023December 31, 2022
Deferred tax assets
Employee and retiree benefit plans$217 $189 
Other insurance and contractholder liabilities353 278 
Loss carryforwards200 205 
Deferred loss - sale of business584 — 
Other accrued liabilities244 265 
Policy acquisition expenses39 36 
Unrealized depreciation on investments and foreign currency translation81 159 
Foreign tax attributes1,827 — 
Other242 190 
Deferred tax assets before valuation allowance3,787 1,322 
Valuation allowance for deferred tax assets(1,498)(208)
Deferred tax assets, net of valuation allowance2,289 1,114 
Deferred tax liabilities
Depreciation and amortization371 512 
Acquisition-related basis differences8,105 8,347 
Other— 41 
Total deferred tax liabilities8,476 8,900 
Net deferred income tax liabilities(1)
$(6,187)$(7,786)
(1)Deferred tax liabilities, net in the Consolidated Balance Sheets as of December 31, 2023, excludes $1,055 million reported in Other assets and $69 million reported in liabilities of businesses held for sale.
Reconciliations of Unrecognized Tax Benefits
Reconciliations of unrecognized tax benefits were as follows:
For the Years Ended December 31,
(In millions)202320222021
Balance at January 1,$1,343 $1,230 $1,210 
(Decrease) / Increase due to prior year positions(26)8 21 
Increase due to current year positions107 137 31 
Reduction related to settlements with taxing authorities(13)(4)(15)
Reduction related to lapse of applicable statute of limitations(12)(28)(17)
Balance at December 31,$1,399 $1,343 $1,230 
v3.24.0.1
Segment Information (Tables)
 12 Months Ended
Dec. 31, 2023
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,
202320222021
(In millions)Pre-taxAfter-taxPre-taxAfter-taxPre-taxAfter-tax
Loss (gain) on sale of businesses$1,499 $1,429 $(1,662)$(1,332)$— $— 
Charge for organizational efficiency plan
 (Selling, general and administrative expenses)		252 193 22 17 168 119 
Charges (benefits) associated with litigation matters
 (Selling, general and administrative expenses)		201 171 (28)(20)(27)(21)
Integration and transaction-related costs
 (Selling, general and administrative expenses)		45 35 135 103 169 71 
Deferred tax (benefits), net
 (Income taxes, less amount attributable to noncontrolling interests)		— (1,071)— — — — 
Debt extinguishment costs — — — — 141 110 
Total impact from special items$1,997 $757 $(1,533)$(1,232)$451 $279 
Summarized Segment Financial Information
Effective January 1, 2023, we adopted amended accounting guidance for long-duration insurance contracts. See Note 2 to the Consolidated Financial Statements for further information. Prior period summarized segment information has been retrospectively adjusted to conform to this new basis of accounting. Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2023
Revenues from external customers$147,588 $46,219 $291 $1 $194,099 
Intersegment revenues5,670 4,332 — (10,002)
Net investment income
241 597 305 23 1,166 
Total revenues153,499 51,148 596 (9,978)195,265 
Net realized investment results from certain equity method investments
— 57 — — 57 
Adjusted revenues$153,499 $51,205 $596 $(9,978)$195,322 
Depreciation and amortization$2,438 $569 $3 $25 $3,035 
Income (loss) before income taxes
$4,768 $2,664 $76 $(1,995)$5,513 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(144)(2)— — (146)
Net realized investment losses (1)
— 133 2 — 135 
Amortization of acquired intangible assets1,774 45 — — 1,819 
Special items
Loss on sale of businesses— 1,481 18 — 1,499 
Charge for organizational efficiency plan— — — 252 252 
Charges associated with litigation matters44 157 — — 201 
Integration and transaction-related costs— — — 45 45 
Pre-tax adjusted income (loss) from operations$6,442 $4,478 $96 $(1,698)$9,318 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
2022
Revenues from external customers
$135,786 $41,738 $1,839 $— $179,363 
Intersegment revenues4,463 2,535 — (6,998)
Net investment income
86 638 424 7 1,155 
Total revenues140,335 44,911 2,263 (6,991)180,518 
Net realized investment results from certain equity method investments— 126 — — 126 
Adjusted revenues$140,335 $45,037 $2,263 $(6,991)$180,644 
Depreciation and amortization$2,283 $638 $6 $10 $2,937 
Income (loss) before income taxes
$4,421 $3,470 $2,101 $(1,595)$8,397 
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 83 — 613 
Amortization of acquired intangible assets1,772 103 1 — 1,876 
Special items
(Gain) on sale of businesses— — (1,662)— (1,662)
Charge for organizational efficiency plan— — — 22 22 
(Benefits) associated with litigation matters— — — (28)(28)
Integration and transaction-related costs— — — 135 135 
Pre-tax adjusted income (loss) from operations$6,127 $4,099 $509 $(1,466)$9,269 
(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
2021
Revenues from external customers$127,692 $41,369 $3,459 $— $172,520 
Intersegment revenues4,203 2,271 — (6,474)
Net investment income (loss)
17 1,003 530 (1)1,549 
Total revenues131,912 44,643 3,989 (6,475)174,069 
Net realized investment results from certain equity method investments— — — — — 
Adjusted revenues$131,912 $44,643 $3,989 $(6,475)$174,069 
Depreciation and amortization$2,316 $551 $52 $4 $2,923 
Income (loss) before income taxes
$3,908 $3,804 $868 $(1,790)$6,790 
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)
4 (247)45 — (198)
Amortization of acquired intangible assets1,937 47 14 — 1,998 
Special items
Charge for organizational efficiency plan— — — 168 168 
(Benefits) associated with litigation matters— — — (27)(27)
Integration and transaction-related costs— — — 169 169 
Debt extinguishment costs — — — 141 141 
Pre-tax adjusted income (loss) from operations$5,818 $3,601 $903 $(1,339)$8,983 
(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. Prior period amounts have been retrospectively adjusted to reflect adoption of amended accounting guidance for long-duration insurance contracts (as discussed in Note 2 to the Consolidated Financial Statements) and to reflect the merger of the U.S. Commercial and U.S. Government operating segments into the U.S. Healthcare operating segment (as discussed in Note 1 to the Consolidated Financial Statements). The following table presents these revenues by product, premium and service type:
For the Years Ended December 31,
(In millions)202320222021
Products (Pharmacy revenues) (ASC 606)
Network revenues$67,514 $64,946 $64,992 
Home delivery and specialty revenues65,732 61,283 54,391 
Other revenues9,047 6,753 6,428 
Intercompany eliminations(5,050)(4,416)(4,398)
Total pharmacy revenues137,243 128,566 121,413 
Insurance premiums (ASC 944)
Cigna Healthcare
U.S. Healthcare
Employer insured16,490 15,199 14,315 
Medicare Advantage8,771 7,896 8,362 
Stop loss6,143 5,461 4,868 
Individual and Family Plans5,088 2,636 2,528 
Other4,095 3,996 5,076 
U.S. Healthcare
40,587 35,188 35,149 
International Health3,295 2,906 2,588 
Total Cigna Healthcare43,882 38,094 37,737 
Divested International businesses— 1,596 3,205 
Other281 225 221 
Intercompany eliminations74 1 (9)
Total premiums44,237 39,916 41,154 
Services (Fees) (ASC 606)
Evernorth Health Services
10,866 7,234 6,070 
Cigna Healthcare
6,566 6,053 5,743 
Other Operations
3 9 19 
Other revenues210 168 188 
Intercompany eliminations(5,026)(2,583)(2,067)
Total fees and other revenues12,619 10,881 9,953 
Total revenues from external customers$194,099 $179,363 $172,520 
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)202320222021
United States$189,840 $174,540 $166,626 
Foreign countries (1)
4,259 4,823 5,894 
Total revenues from external customers$194,099 $179,363 $172,520 
(1) The divested International businesses as described in Note 5 comprised of $1.6 billion and $3.2 billion in 2022 and 2021, respectively.
v3.24.0.1
SEC Schedule, Article 12-04, Condensed Financial Information of Registrant (Tables)
 12 Months Ended
Dec. 31, 2023
Condensed Financial Information Disclosure [Abstract]  
Summary of Debt Issuances
On March 7, 2023, the Company issued $1.5 billion of new senior notes. The proceeds of this issuance were used for general
corporate purposes, and included repayment of outstanding debt securities. Interest on this debt is paid semi-annually.

PrincipalMaturity DateInterest RateNet Proceeds
$700 million (1)
March 15, 20265.685%$698 million
$800 million (2)
March 15, 20335.400%$796 million
(1) Redeemable at any time discounted at the U.S. Treasury rate plus 20 basis points. Redeemable at par on or after March 15, 2024.
(2) Redeemable at any time discounted at the U.S. Treasury rate plus 25 basis points. Redeemable at par on or after December 15, 2032.
Schedule of Maturities of Long-Term Debt Maturities of the Company's long-term debt are as follows and exclude the impacts of the 2024 debt issuance and debt tender offers discussed above.
(In millions) 
2024$1,214 
2025$2,957 
2026$2,734 
2027$2,056 
2028$3,800 
Maturities after 2028$15,091 
v3.24.0.1
Description of Business (Details) - Medicare Advantage and related Cigna Healthcare businesses - Held-for-Sale - Subsequent Event
$ in Billions
 1 Months Ended
Jan. 31, 2024
USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]  
Disposal Group, Not Discontinued Operation, Name of Segment [Extensible Enumeration] Cigna Healthcare
Health Care Service Corporation (HCSC)  
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]  
Sale price $ 3.3
v3.24.0.1
Summary of Significant Accounting Policies (Details) - USD ($)
$ / shares in Units, $ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
New Accounting Pronouncements or Change in Accounting Principle [Line Items]        
Decrease to shareholders' equity $ (46,244) $ (44,688) [1] $ (46,976) $ (50,189)
Increase to shareholders' net income $ 5,164 $ 6,704 [1] $ 5,370 [1]  
Increase to diluted earnings per share (in dollars per share) $ 17.39 $ 21.41 [1] $ 15.75 [1]  
Revision of Prior Period, Accounting Standards Update, Adjustment        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]        
Decrease to shareholders' equity       $ 139
Increase to shareholders' net income   $ 36 $ 5  
Increase to diluted earnings per share (in dollars per share)   $ 0.11 $ 0.02  
Pharmacy Benefits Management Services | Guarantees        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]        
Performance guarantee liability $ 1,600 $ 1,300    
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  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Accounts Receivable, Net - Amounts Included in Accounts Receivable, Net (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Accounts, Notes, Loans and Financing Receivable [Line Items]    
Pharmaceutical manufacturer receivables   $ 7,108
Noninsurance customer receivables   6,899
Insurance customer receivables   2,963
Other receivables   248
Pharmaceutical manufacturers receivable, including held for sale assets $ 8,169  
Noninsurance customer receivables, including held for sale assets 8,044  
Insurance customer receivables, including held for sale assets 2,359  
Other receivables, including held for sale assets 272  
Total 18,844  
Accounts receivable, net 17,722 $ 17,218 [1]
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Accounts, Notes, Loans and Financing Receivable [Line Items]    
Accounts receivable, net classified as assets of businesses held for sale $ (1,122)  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Accounts Receivable, Net - Narrative (Details) - USD ($)
$ in Millions
 1 Months Ended 12 Months Ended
Jul. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
Receivables [Abstract]      
Allowance for receivables, current   $ 3,700 $ 1,900
Pharmaceutical manufacturers receivables allowance   3,100 1,300
Noninsurance customer receivables allowance   386 336
Remaining allowances   219 226
Allowance for current expected credit losses on accounts receivable   90 $ 86
Total capacity, uncommitted factoring facility $ 1,000    
Initial term, uncommitted factoring facility (in years) 2 years    
Automatic renewal term, uncommitted factoring facility (in years) 1 year    
Accounts receivable sold, uncommitted factoring facility   2,100  
Accounts receivable received but not remitted, uncommitted factoring facility   $ 515  
v3.24.0.1
Supplier Finance Program (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Payables and Accruals [Abstract]    
Payment term (in months) 1 month  
Outstanding payment obligations, current $ 1,500 $ 1,300
Outstanding payment obligations, current, voluntarily elected by suppliers to be sold to the financial institution $ 298  
Supplier Finance Program, Obligation, Current, Statement of Financial Position [Extensible Enumeration] Accounts payable Accounts payable
v3.24.0.1
Mergers, Acquisitions and Divestitures - Narrative (Details) - USD ($)
$ in Millions
 12 Months Ended
Jul. 01, 2022
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]        
Integration and transaction-related costs, pre-tax   $ 45 $ 135 $ 169
Integration and transaction-related costs, after-tax   35 $ 103 $ 71
CHSS JV LLC | Guarantee of CHSS' credit facilities        
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]        
Maximum guarantee exposure   $ 125    
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      
v3.24.0.1
Assets and Liabilities of Businesses Held for Sale (Details) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Jul. 01, 2022
Dec. 31, 2023
Dec. 31, 2023
Jan. 31, 2024
Dec. 31, 2021
Medicare Advantage and related Cigna Healthcare businesses | Held-for-Sale          
Disposal Group, Including Discontinued Operation, Balance Sheet Disclosures [Abstract]          
Cash and cash equivalents   $ 467 $ 467    
Investments   1,438 1,438    
Accounts receivable, net   1,122 1,122    
Other assets, including Goodwill   2,963 2,963    
Goodwill classified as Assets of businesses held for sale   396 396    
Total assets of businesses held for sale   5,990 5,990    
Insurance and contractholder liabilities   1,636 1,636    
All other liabilities   1,059 1,059    
Total liabilities of businesses held for sale   2,695 $ 2,695    
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax [Abstract]          
Estimated loss on sale, pre-tax   1,500      
Estimated loss on sale, after-tax   $ 1,400      
Loss on sale of businesses, location, Consolidated Statements of Income     (Loss) gain on sale of businesses    
Medicare Advantage and related Cigna Healthcare businesses | Held-for-Sale | Health Care Service Corporation (HCSC) | Subsequent Event          
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]          
Sale price       $ 3,300  
International life, accident and supplemental benefits businesses | Held-for-Sale          
Disposal Group, Including Discontinued Operation, Balance Sheet Disclosures [Abstract]          
Goodwill classified as Assets of businesses held for sale         $ 234
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        
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax [Abstract]          
Estimated loss on sale, pre-tax (1,700)        
Estimated loss on sale, after-tax $ (1,400)        
v3.24.0.1
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, 2023
Dec. 31, 2022
Dec. 31, 2021
Earnings Per Share [Abstract]      
Shareholders' net income $ 5,164 $ 6,704 [1] $ 5,370 [1]
Shares:      
Weighted average (in shares) 293,892 309,546 337,962
Common stock equivalents (in shares) 2,990 3,519 3,004
Total shares (in shares) 296,882 313,065 340,966
EPS, basic (in dollars per share) $ 17.57 $ 21.66 [1] $ 15.89 [1]
EPS, effect of dilution (in dollars per share) (0.18) (0.25) (0.14)
EPS, diluted (in dollars per share) $ 17.39 $ 21.41 [1] $ 15.75 [1]
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
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, 2023
Dec. 31, 2022
Dec. 31, 2021
Employee Stock Options      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Antidilutive options (in shares) 0.9 1.0 1.5
v3.24.0.1
Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares
shares in Thousands
 1 Months Ended 6 Months Ended
Nov. 30, 2022
Jul. 31, 2022
Dec. 31, 2022
Dec. 31, 2023
Dec. 31, 2021
Earnings Per Share [Abstract]          
Shares of common stock held in treasury     99,143 107,390 71,246
Stock repurchased (in shares) 1,900 10,400 12,300    
v3.24.0.1
Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)
Dec. 31, 2023
Jan. 15, 2023
Dec. 31, 2022
Short-term debt      
Commercial paper $ 1,237,000,000   $ 0
Other, including finance leases 42,000,000   33,000,000
Total short-term debt 2,775,000,000   2,993,000,000 [1]
Long-term debt      
Other, including finance leases 66,000,000   66,000,000
Total long-term debt 28,155,000,000   28,100,000,000 [1]
$17 million, 8.3% Notes due January 2023      
Short-term debt      
Current maturities 0   17,000,000
Long-term debt      
Gross value $ 17,000,000    
Interest Rate 8.30%    
$63 million, 7.65% Notes due March 2023      
Short-term debt      
Current maturities $ 0   63,000,000
Long-term debt      
Gross value $ 63,000,000    
Interest Rate 7.65%    
$700 million, Floating Rate Notes due July 2023      
Short-term debt      
Current maturities $ 0   700,000,000
Long-term debt      
Gross value 700,000,000    
$1,000 million, 3% Notes due July 2023      
Short-term debt      
Current maturities 0   994,000,000
Long-term debt      
Gross value $ 1,000,000,000    
Interest Rate 3.00%    
$1,187 million, 3.75% Notes due July 2023      
Short-term debt      
Current maturities $ 0   1,186,000,000
Long-term debt      
Gross value $ 1,187,000,000    
Interest Rate 3.75%    
$500 million, 0.613% Notes due March 2024      
Short-term debt      
Current maturities $ 500,000,000   0
Long-term debt      
Long-term debt 0   499,000,000
Gross value $ 500,000,000    
Interest Rate 0.613%    
$1,000 million, 3.500% Notes due June 2024      
Short-term debt      
Current maturities $ 996,000,000   0
Long-term debt      
Long-term debt 0   990,000,000
Gross value $ 1,000,000,000    
Interest Rate 3.50%    
$900 million, 3.250% Notes due April 2025 (2)      
Long-term debt      
Long-term debt $ 882,000,000   872,000,000
Gross value $ 900,000,000    
Interest Rate 3.25%    
$2,200 million, 4.125% Notes due November 2025 (1)      
Long-term debt      
Long-term debt $ 2,197,000,000   2,195,000,000
Gross value $ 2,200,000,000    
Interest Rate 4.125%    
$1,500 million, 4.500% Notes due February 2026 (1)      
Long-term debt      
Long-term debt $ 1,502,000,000   1,503,000,000
Gross value $ 1,500,000,000    
Interest Rate 4.50%    
$800 million, 1.250% Notes due March 2026 (1)      
Long-term debt      
Long-term debt $ 798,000,000   797,000,000
Gross value $ 800,000,000    
Interest Rate 1.25%    
$700 million, 5.685% Notes due March 2026      
Long-term debt      
Long-term debt $ 698,000,000   0
Gross value $ 700,000,000    
Interest Rate 5.685%    
$1,500 million, 3.400% Notes due March 2027      
Long-term debt      
Long-term debt $ 1,450,000,000   1,436,000,000
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, 3.050% Notes due October 2027 (1)      
Long-term debt      
Long-term debt $ 597,000,000   597,000,000
Gross value $ 600,000,000    
Interest Rate 3.05%    
$3,800 million, 4.375% Notes due October 2028      
Long-term debt      
Long-term debt $ 3,787,000,000   3,785,000,000
Gross value $ 3,800,000,000    
Interest Rate 4.375%    
$1,500 million, 2.400% Notes due March 2030 (1)      
Long-term debt      
Long-term debt $ 1,493,000,000   1,492,000,000
Gross value $ 1,500,000,000    
Interest Rate 2.40%    
$1,500 million, 2.375% Notes due 2031      
Long-term debt      
Long-term debt $ 1,397,000,000   1,380,000,000
Gross value $ 1,500,000,000    
Interest Rate 2.375%    
$45 million, 8.080% Step Down Notes due January 2033 (3)      
Long-term debt      
Long-term debt $ 45,000,000   45,000,000
Gross value $ 45,000,000    
Interest Rate 8.08% 8.08%  
$800 million, 5.400% Notes due March 2033      
Long-term debt      
Long-term debt $ 794,000,000   0
Gross value $ 800,000,000    
Interest Rate 5.40%    
$190 million, 6.150% 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, 4.800% Notes due August 2038      
Long-term debt      
Long-term debt $ 2,193,000,000   2,192,000,000
Gross value $ 2,200,000,000    
Interest Rate 4.80%    
$750 million, 3.200% Notes due March 2040      
Long-term debt      
Long-term debt $ 744,000,000   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 $ 487,000,000   488,000,000
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, 4.800% Notes due July 2046      
Long-term debt      
Long-term debt $ 1,467,000,000   1,466,000,000
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   989,000,000
Gross value $ 1,000,000,000    
Interest Rate 3.875%    
$3,000 million, 4.900% Notes due December 2048      
Long-term debt      
Long-term debt $ 2,970,000,000   2,968,000,000
Gross value $ 3,000,000,000    
Interest Rate 4.90%    
$1,250 million, 3.400% Notes due March 2050      
Long-term debt      
Long-term debt $ 1,237,000,000   1,236,000,000
Gross value $ 1,250,000,000    
Interest Rate 3.40%    
$1,500 million, 3.400% Notes due March 2051      
Long-term debt      
Long-term debt $ 1,479,000,000   $ 1,478,000,000
Gross value $ 1,500,000,000    
Interest Rate 3.40%    
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Debt - Short-term and Credit Facilities Debt (Details)
 1 Months Ended 12 Months Ended
Apr. 30, 2023
USD ($)
revolvingCreditFacility
position
Apr. 30, 2022
USD ($)
Dec. 31, 2023
USD ($)
Debt Instrument [Line Items]      
Commercial paper average interest rate     5.63%
Commercial Paper      
Debt Instrument [Line Items]      
Maximum borrowing capacity     $ 5,000,000,000
Revolving credit agreements, 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 revolving credit facilities | revolvingCreditFacility 2    
Number of participating banks | position 21    
Leverage ratio covenant 60.00%    
Five-year Revolving Credit Agreement, Maturing April 2028      
Debt Instrument [Line Items]      
Maximum borrowing capacity $ 4,000,000,000    
Credit agreement term 5 years    
Credit agreement extension term 1 year    
Five-year Revolving Credit Agreement, Maturing April 2028 | Letter of Credit      
Debt Instrument [Line Items]      
Maximum borrowing capacity $ 500,000,000    
364-day Revolving Credit Agreement, Maturing April 2024      
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    
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  
Revolving Credit Facility Maturing April 2025      
Debt Instrument [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   3 years  
364 Day Revolving Credit Agreement, Maturing April 2023      
Debt Instrument [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   364 days  
v3.24.0.1
Debt - Long-term Debt (Details)
 12 Months Ended
Mar. 07, 2023
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
 [1]
Dec. 31, 2021
USD ($)
 [1]
Feb. 22, 2024
USD ($)
Feb. 05, 2024
USD ($)
Debt Instrument [Line Items]            
Loss on repurchase of debt, pre-tax   $ 0 $ 0 $ 141,000,000    
Repayment of long-term debt   $ 2,967,000,000 $ 500,000,000 $ 4,578,000,000    
Forecast            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed         $ 2,550,000,000 $ 2,250,000,000
Subsequent Event            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed         $ 1,800,000,000  
Senior Notes            
Debt Instrument [Line Items]            
Principal $ 1,500,000,000          
$700 million, 5.685% Notes due March 2026            
Debt Instrument [Line Items]            
Interest rate   5.685%        
Gross value   $ 700,000,000        
$700 million, 5.685% Notes due March 2026 | Senior Notes            
Debt Instrument [Line Items]            
Principal $ 700,000,000          
Interest rate 5.685%          
Net proceeds $ 698,000,000          
$700 million, 5.685% Notes due March 2026 | Senior Notes | Treasury rate            
Debt Instrument [Line Items]            
Redemption price discount, spread on variable rate 0.0020          
$800 million, 5.400% Notes due March 2033            
Debt Instrument [Line Items]            
Interest rate   5.40%        
Gross value   $ 800,000,000        
$800 million, 5.400% Notes due March 2033 | Senior Notes            
Debt Instrument [Line Items]            
Principal $ 800,000,000          
Interest rate 5.40%          
Net proceeds $ 796,000,000          
$800 million, 5.400% Notes due March 2033 | Senior Notes | Treasury rate            
Debt Instrument [Line Items]            
Redemption price discount, spread on variable rate 0.0025          
$1,000 million, 3.500% Notes due June 2024            
Debt Instrument [Line Items]            
Interest rate   3.50%        
Gross value   $ 1,000,000,000        
$1,000 million, 3.500% Notes due June 2024 | Forecast            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed           $ 1,000,000,000
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Debt - Debt Maturities (Details)
$ in Millions
Dec. 31, 2023
USD ($)
Long-term Debt  
2024 $ 1,500
2025 3,100
2026 3,000
2027 2,359
2028 3,800
Maturities after 2028 $ 16,122
v3.24.0.1
Debt - Interest Expense (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Debt Disclosure [Abstract]      
Interest expense on long-term and short-term debt $ 1,400 $ 1,300 $ 1,300
v3.24.0.1
Common and Preferred Stock - Share Activity (Details) - $ / shares
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
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      
Outstanding - beginning balance (in shares) 298,676,000 322,948,000 354,771,000
Issued for stock option exercises and other benefit plans (in shares) 1,619,000 3,173,000 3,375,000
Repurchased common stock (in shares) (7,791,000) (27,445,000) (35,198,000)
Outstanding - ending balance (in shares) 292,504,000 298,676,000 322,948,000
Treasury stock (in shares) 107,390,000 99,143,000 71,246,000
Common stock, shares issued (in shares) 399,894,000 397,819,000 394,194,000
v3.24.0.1
Common and Preferred Stock - Dividends (Details) - USD ($)
$ / shares in Units, $ in Millions
 3 Months Ended 12 Months Ended
Feb. 02, 2024
Dec. 21, 2023
Sep. 21, 2023
Jun. 22, 2023
Mar. 23, 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
Dec. 31, 2023
Sep. 30, 2023
Jun. 30, 2023
Mar. 31, 2023
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, 2023
Dec. 31, 2022
Dec. 31, 2021
Subsequent Event [Line Items]                                                        
Common dividends declared (in dollars per share)                           $ 1.23 $ 1.23 $ 1.23 $ 1.23 $ 1.12 $ 1.12 $ 1.12 $ 1.12 $ 1.00 $ 1.00 $ 1.00 $ 1.00 $ 4.92 $ 4.48 $ 4.00
Amount per share (in dollars per share)   $ 1.23 $ 1.23 $ 1.23 $ 1.23 $ 1.12 $ 1.12 $ 1.12 $ 1.12 $ 1.00 $ 1.00 $ 1.00 $ 1.00                              
Total amount paid   $ 358 $ 362 $ 362 $ 368 $ 334 $ 341 $ 352 $ 357 $ 324 $ 330 $ 342 $ 345                         $ 1,450 $ 1,384 [1] $ 1,341 [1]
Subsequent Event                                                        
Subsequent Event [Line Items]                                                        
Common dividends declared (in dollars per share) $ 1.40                                                      
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Common and Preferred Stock - Accelerated Share Repurchase Agreements (Details) - USD ($)
$ / shares in Units, shares in Millions
 1 Months Ended 6 Months Ended 12 Months Ended
Feb. 15, 2024
Nov. 30, 2022
Jul. 31, 2022
Dec. 31, 2022
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Jun. 30, 2022
Accelerated Share Repurchases [Line Items]                
Accelerated stock repurchase, amount authorized               $ 3,500,000,000
Accelerated stock repurchase, amount remitted     $ 3,500,000,000          
Stock repurchased (in shares)   1.9 10.4 12.3        
Stock repurchased         $ 2,282,000,000 $ 7,593,000,000 $ 7,710,000,000  
Accelerated stock repurchase, volume weighted average share price (in dollars per share)       $ 285.10        
Subsequent Event                
Accelerated Share Repurchases [Line Items]                
Accelerated stock repurchase, amount authorized $ 3,200,000,000              
Accelerated stock repurchase, amount remitted $ 3,200,000,000              
Stock repurchased (in shares) 7.6              
Treasury Stock                
Accelerated Share Repurchases [Line Items]                
Stock repurchased     $ 2,800,000,000   2,282,000,000 $ 7,593,000,000 $ 7,710,000,000  
Treasury Stock | Subsequent Event                
Accelerated Share Repurchases [Line Items]                
Stock repurchased $ 2,600,000,000              
Additional Paid-in Capital                
Accelerated Share Repurchases [Line Items]                
Stock repurchased         $ 0      
v3.24.0.1
Insurance and Contractholder Liabilities - Account Balances (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Current        
Market risk benefits, current $ 37 $ 51    
Unearned premiums, current   576    
Unearned premiums, current, including held for sale liabilities 846      
Total, current 6,633      
Current insurance and contractholder liabilities 5,514 5,409 [1]    
Non-current        
Market risk benefits, non-current 966 1,217    
Unearned premiums, non-current   22    
Unearned premiums, non-current, including held for sale liabilities 22      
Total, non-current 11,421      
Non-current insurance and contractholder liabilities 10,904 11,976 [1]    
Total        
Market risk benefits 1,003 1,268    
Unearned premiums   598    
Unearned premiums, including held for sale liabilities 868      
Total 18,054      
Total insurance and contractholder liabilities 16,418 17,385    
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses        
Current        
Insurance and contractholder liabilities current, classified as held for sale (1,119)      
Non-current        
Insurance and contractholder liabilities, non-current, classified as held for sale (517)      
Total        
Insurance and contractholder liabilities classified as held for sale (1,636)      
Unpaid claims classified as liabilities of business held for sale 823      
Future policy benefits classified as liabilities of business held for sale 429      
Unearned premiums classified as liabilities of business held for sale 261      
Contractholder deposit funds classified as liabilities held for sale 123      
Cigna Healthcare        
Current        
Unpaid claims and claim expenses, current   4,117    
Unpaid claims and claim expenses, current, including held for sale liabilities 5,017      
Future policy benefits, current   43    
Future policy benefits, current, including held for sale liabilities 97      
Contractholder deposit funds, current   14    
Contractholder deposit funds, current, including held for sale liabilities 12      
Non-current        
Unpaid claims and claim expenses, non-current   59    
Unpaid claims and claim expenses, non-current, including held for sale liabilities 75      
Future policy benefits, non-current   544    
Future policy benefits, non-current, including held for sale liabilities 518      
Contractholder deposit funds, non-current   157    
Contractholder deposit funds, non-current, including liabilities held for sale 133      
Total        
Unpaid claims and claim expenses   4,176 $ 4,261 $ 3,695
Unpaid claims and claim expenses, including held for sale liabilities 5,092      
Total liability for future policy benefits   587    
Future policy benefits, including held for sale liabilities 615      
Contractholder deposit funds   171    
Contractholder deposit funds, including liabilities held for sale 145      
Other Operations        
Current        
Unpaid claims and claim expenses, current 99 107    
Future policy benefits, current 163 150    
Contractholder deposit funds, current 362 351    
Non-current        
Unpaid claims and claim expenses, non-current 154 177    
Future policy benefits, non-current 3,375 3,442    
Contractholder deposit funds, non-current 6,178 6,358    
Total        
Unpaid claims and claim expenses 253 284    
Total liability for future policy benefits 3,538 3,592    
Contractholder deposit funds $ 6,540 $ 6,709 $ 6,900  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Cigna Healthcare - Activity (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses      
Paid costs related to:      
Unpaid claims classified as liabilities of business held for sale $ 823    
Cigna Healthcare      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Total of incurred but not reported liabilities plus expected claim development on reported claims, including reported claims in process 4,800 $ 3,900  
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]      
Beginning balance 4,176 4,261 $ 3,695
Less: Reinsurance and other amounts recoverable 221 261 237
Beginning balance, net 3,955 4,000 3,458
Incurred costs related to:      
Current year 35,953 31,342 31,755
Prior years (279) (259) (219)
Total incurred 35,674 31,083 31,536
Paid costs related to:      
Current year 31,322 27,583 27,929
Prior years 3,451 3,545 3,065
Total paid 34,773 31,128 30,994
Ending balance, net   3,955 4,000
Add: Reinsurance and other amounts recoverable   221 261
Ending balance (1)   $ 4,176 $ 4,261
Ending balance, net, including held for sale liabilities 4,856    
Add: Reinsurance, including held for sale liabilities 236    
Ending balance, including held for sale liabilities $ 5,092    
v3.24.0.1
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, 2023
Dec. 31, 2022
Dec. 31, 2021
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]      
Favorable (unfavorable) variance, amount $ 279 $ 259 $ 219
Favorable (unfavorable) variance, percentage 0.90% 0.80%  
Actual completion factors      
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]      
Favorable (unfavorable) variance, amount $ 70 $ 62  
Favorable (unfavorable) variance, percentage 0.20% 0.20%  
Medical cost trend      
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]      
Favorable (unfavorable) variance, amount $ 209 $ 197  
Favorable (unfavorable) variance, percentage 0.70% 0.60%  
v3.24.0.1
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
 12 Months Ended
Dec. 31, 2023
USD ($)
claim
Dec. 31, 2022
USD ($)
claim
Claims Development [Line Items]    
Incurred Costs, including assets held for sale $ 64,928  
Cumulative Costs Paid, including assets held for sale 60,221  
Outstanding liabilities for the periods presented, net of reinsurance, including assets held for sale 4,707  
Other long-duration liabilities not included in development table above, including assets held for sale 149  
Net unpaid claims and claims expenses - Cigna Healthcare 4,856  
Reinsurance and other amounts recoverable, including assets held for sale 236  
Unpaid claims and claim expenses, including held for sale liabilities $ 5,092  
Percent of health claims paid within one year 95.00%  
Claim frequency | claim 5.5 5.0
Incurral Year - 2022    
Claims Development [Line Items]    
Incurred Costs, including assets held for sale $ 30,050 $ 30,309
Cumulative Costs Paid, including assets held for sale 29,841 $ 26,687
Outstanding liabilities for the periods presented, net of reinsurance, including assets held for sale 209  
Incurral Year - 2023    
Claims Development [Line Items]    
Incurred Costs, including assets held for sale 34,878  
Cumulative Costs Paid, including assets held for sale 30,380  
Outstanding liabilities for the periods presented, net of reinsurance, including assets held for sale $ 4,498  
v3.24.0.1
Insurance and Contractholder Liabilities - Future Policy Benefits - Interest Rates and Duration (Details)
Dec. 31, 2023
Dec. 31, 2022
Cigna Healthcare    
Insurance and Contractholder Liabilities [Line Items]    
Interest accretion rate 2.54% 2.58%
Current discount rate 4.92% 5.57%
Weighted average duration 7 years 10 months 24 days 7 years 8 months 12 days
Other Operations    
Insurance and Contractholder Liabilities [Line Items]    
Interest accretion rate 5.64% 5.64%
Current discount rate 4.87% 5.19%
Weighted average duration 11 years 4 months 24 days 11 years 6 months
v3.24.0.1
Insurance and Contractholder Liabilities - Future Policy Benefits - Present Value of Expected Premiums and Benefits (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]      
Observable inputs from published spot rate curve term (in years) 30 years    
Percent of the liability for future policy benefits supported by assets held in trust 34.00%    
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses      
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]      
Future policy benefits classified as liabilities of business held for sale $ 429    
Cigna Healthcare      
Liability for Future Policy Benefit, Expected Net Premium [Roll Forward]      
Beginning balance 8,557 $ 9,314  
Reversal of effect of beginning of period discount rate assumptions 1,537 (367)  
Effect of assumption changes and actual variances from expected experience (1)   314 $ 1,286
Issuances and lapses 1,255 1,067  
Net premiums collected (1,370) (1,280)  
Interest and other 94 74  
Ending balance at original discount rate 10,387 10,094  
Effect of end of period discount rate assumptions (1,154) (1,537)  
Ending balance 9,233 8,557 9,314
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]      
Beginning balance 8,945 9,794  
Reversal of effect of discount rate assumptions 1,611 (379)  
Effect of assumption changes and actual variances from expected experience (1)   112 1,148
Issuances and lapses 1,309 1,176  
Benefit payments (1,374) (1,401)  
Interest and other 250 218  
Ending balance at original discount rate 10,853 10,556  
Effect of discount rate assumptions (1,220) (1,611)  
Ending balance 9,633 8,945 9,794
Liability for future policy benefits 400 388  
Other 215 199  
Total liability for future policy benefits   587  
Total liability for future policy benefits, including assets held for sale 615    
Effect of actual variances from expectations (12) 46  
Undiscounted expected future gross premiums 18,700 17,500  
Discounted expected future gross premiums 13,500 12,200  
Undiscounted expected future policy benefits 13,300 12,700  
Future policy benefits reserve, reinsurance recoverables 72 155  
Cigna Healthcare | Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses      
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]      
Future policy benefits reserve, reinsurance recoverables reported in assets of businesses held for sale 79    
Other Operations      
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]      
Total liability for future policy benefits 3,538 3,592  
Undiscounted expected future policy benefits 4,500 4,600  
Future policy benefits reserve, reinsurance recoverables 1,000 1,100  
Future policy benefits, DPL 384 390  
Future policy benefit, excluding DPL $ 3,200 $ 3,200 4,300
Other Operations | Disposed of by Sale | International life, accident and supplemental benefits businesses      
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]      
Future policy benefits classified as liabilities of business held for sale     $ 3,800
v3.24.0.1
Insurance and Contractholder Liabilities - Contractholder Deposit Funds (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit fund liabilities, approximate percent reinsured externally 39.00%    
Cigna Healthcare      
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit funds   $ 171  
Other Operations      
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit funds $ 6,540 $ 6,709 $ 6,900
Weighted average crediting rate 3.31% 3.08%  
Net amount at risk $ 3,000 $ 3,000  
Cash surrender value $ 2,800 $ 2,400  
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400      
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit funds not reinsured externally, percent with guaranteed interest rates of 0300 to 0400 99.00% 99.00%  
Contractholder deposit funds not reinsured externally $ 4,000 $ 4,100  
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400 | Policyholder Account Balance, at Guaranteed Minimum Crediting Rate      
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit funds not reinsured externally 1,200 1,200  
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400 | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150      
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit funds not reinsured externally 1,200 1,200  
Other Operations | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400 | Policyholder Account Balance, Above Guaranteed Minimum Crediting Rate, Based On Greater Of Guaranteed Minimum Cash Value Or Actual Cash Value      
Insurance and Contractholder Liabilities [Line Items]      
Contractholder deposit funds not reinsured externally $ 1,600 $ 1,700  
Percentage with cash values at more than 110% of guaranteed cash value 90.00% 90.00%  
Other Operations | Minimum | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150      
Insurance and Contractholder Liabilities [Line Items]      
Above guaranteed minimum crediting rate 0.0050 0.0050  
Other Operations | Minimum | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400      
Insurance and Contractholder Liabilities [Line Items]      
Guaranteed minimum credit rating 3.00% 3.00%  
Other Operations | Maximum | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150      
Insurance and Contractholder Liabilities [Line Items]      
Above guaranteed minimum crediting rate 0.0150 0.0150  
Other Operations | Maximum | Policyholder Account Balance, Guaranteed Minimum Crediting Rate, Range from 0300 To 0400      
Insurance and Contractholder Liabilities [Line Items]      
Guaranteed minimum credit rating 4.00% 4.00%  
v3.24.0.1
Insurance and Contractholder Liabilities - Summary of Market Risk Benefit (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Insurance Loss Reserves [Abstract]    
Annuitization election period 30 days  
Market Risk Benefit [Roll Forward]    
Balance, beginning of year $ 1,268 $ 1,824
Balance, beginning of year, before the effect of nonperformance risk (own credit risk) 1,379 1,949
Changes due to expected run-off (19) (54)
Changes due to capital markets versus expected (254) (567)
Changes due to policyholder behavior versus expected (5) (14)
Assumption changes (16) 65
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk) 1,085 1,379
Nonperformance risk (own credit risk), end of period (82) (111)
Balance, end of period 1,003 1,268
Reinsured market risk benefit, end of period $ 1,081 $ 1,374
v3.24.0.1
Insurance and Contractholder Liabilities - Net Amount of Risk and Average Age of Contractholders (Details) - Variable Annuity
position in Thousands, $ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
position
Dec. 31, 2022
USD ($)
position
Net Amount at Risk by Product and Guarantee [Line Items]    
Account value $ 7,736 $ 7,436
Net amount at risk $ 1,609 $ 2,494
Average attained age of contractholders (weighted by exposure) 77 years 3 months 18 days 74 years 8 months 12 days
Guaranteed Minimum Death Benefits Total Contractholders | position 140 150
v3.24.0.1
Reinsurance - Reinsurance Recoverables (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale $ 4,180  
Allowance for uncollectible reinsurance, including assets held for sale (35)  
Market risk benefits 1,081 $ 1,374
Total reinsurance recoverables, including assets held for sale 5,226  
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Ceded Credit Risk [Line Items]    
Reinsurance recoverable classified as assets of businesses held for sale 208  
Other Current Assets    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables 183  
Berkshire Hathway Life Insurance Company Of Nebraska and Other Recoverables    
Ceded Credit Risk [Line Items]    
Market risk benefits 1,081  
Fair value of collateral contractually required to meet or exceed carrying value of recoverable    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 658  
Collateral provisions exist that may mitigate risk of credit loss    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 3,043  
No collateral    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 479  
Variable Annuity | Berkshire Hathway Life Insurance Company Of Nebraska and Other Recoverables    
Ceded Credit Risk [Line Items]    
Market risk benefits   1,400
Variable Annuity | Berkshire Hathway Life Insurance Company Of Nebraska and Other Recoverables | GMDB    
Ceded Credit Risk [Line Items]    
Market risk benefits   $ 711
Ongoing Operations    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 487  
Ongoing Operations | A- equivalent and higher current ratings    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 90  
Ongoing Operations | BBB- to BBB+ equivalent current credit ratings    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 59  
Ongoing Operations | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 338  
Ongoing Operations | Fair value of collateral contractually required to meet or exceed carrying value of recoverable    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 151  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 151  
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 5  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 0  
Ongoing Operations | Collateral provisions exist that may mitigate risk of credit loss | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 5  
Ongoing Operations | No collateral    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 331  
Ongoing Operations | No collateral | A- equivalent and higher current ratings    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 90  
Ongoing Operations | No collateral | BBB- to BBB+ equivalent current credit ratings    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 59  
Ongoing Operations | No collateral | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 182  
Acquisition, disposition or run-off activities    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 3,693  
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 before market risk benefits, including assets held for sale 2,656  
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Empower Annuity Insurance Company    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 130  
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Prudential Insurance Company of America    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 341  
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 before market risk benefits, including assets held for sale 356  
Acquisition, disposition or run-off activities | BBB+ equivalent and higher current ratings | Other    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 199  
Acquisition, disposition or run-off activities | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 11  
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 before market risk benefits, including assets held for sale 507  
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 before market risk benefits, including assets held for sale 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 | Empower Annuity Insurance Company    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 341  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 166  
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 before market risk benefits, including assets held for sale 0  
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 3,038  
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 before market risk benefits, including assets held for sale 2,656  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 356  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 7  
Acquisition, disposition or run-off activities | No collateral    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 148  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 130  
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 before market risk benefits, including assets held for sale 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 before market risk benefits, including assets held for sale 0  
Acquisition, disposition or run-off activities | No collateral | BBB+ equivalent and higher current ratings | Other    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 14  
Acquisition, disposition or run-off activities | No collateral | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale $ 4  
v3.24.0.1
Reinsurance - Effects of Reinsurance (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Premiums      
Total premiums $ 44,237 $ 39,916 [1] $ 41,154 [1]
Total reinsurance recoveries      
Total reinsurance recoveries 456 702 552
Short-duration contracts      
Premiums      
Direct 42,266 36,747 36,513
Assumed 303 416 335
Ceded (277) (265) (148)
Total premiums 42,292 36,898 36,700
Total reinsurance recoveries      
Written premiums 41,100 35,000 35,600
Long-duration contracts      
Premiums      
Direct 2,084 3,219 4,753
Assumed 72 85 99
Ceded (211) (286) (398)
Total premiums $ 1,945 $ 3,018 $ 4,454
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Reinsurance - Effective Exit of Variable Annuity Reinsurance Business (Details) - Variable Annuity - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 1,100 $ 1,398  
Incurred but not yet paid and outstanding claims 19 27  
Premiums due   3  
Impact of non-performance risk
Berkshire      
Ceded Credit Risk [Line Items]      
Percent of future claim payments reinsured 100.00%    
Remaining overall limit under reinsurance agreement $ 3,100    
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 873 1,116  
Berkshire | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk      
Ceded Credit Risk [Line Items]      
Concentration percentage 95.00%    
Sun Life Assurance Company of Canada      
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 92 115  
Liberty Re (Bermuda) Ltd.      
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 104 128  
Liberty Re (Bermuda) Ltd. | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk      
Ceded Credit Risk [Line Items]      
Concentration percentage 100.00%    
SCOR SE      
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 31 $ 39  
SCOR SE | Secured | Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due | Collateralization risk      
Ceded Credit Risk [Line Items]      
Concentration percentage 80.00%    
v3.24.0.1
Investments - Investments by Category (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Current    
Investments including held for sale assets $ 1,009  
Current investments 925 $ 905 [1]
Long-term    
Investments including held for sale assets 19,339  
Investments per Consolidated Balance Sheets 17,985 16,288 [1]
Total    
Investments including held for sale assets 20,348  
Total investments 18,910 17,193
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Current    
Investments classified as assets of business held for sale (84)  
Long-term    
Investments classified as assets of business held for sale (1,354)  
Total    
Investments classified as assets of business held for sale (1,438)  
Debt securities    
Current    
Investments including held for sale assets 590  
Current investments   654
Long-term    
Investments including held for sale assets 9,265  
Investments per Consolidated Balance Sheets   9,218
Total    
Investments including held for sale assets 9,855  
Total investments   9,872
Equity securities    
Current    
Investments including held for sale assets 31  
Current investments   45
Long-term    
Investments including held for sale assets 3,331  
Investments per Consolidated Balance Sheets   577
Total    
Investments including held for sale assets 3,362  
Total investments   622
Commercial mortgage loans    
Current    
Investments including held for sale assets 182  
Current investments   67
Long-term    
Investments including held for sale assets 1,351  
Investments per Consolidated Balance Sheets   1,547
Total    
Investments including held for sale assets 1,533  
Total investments   1,614
Policy loans    
Current    
Investments including held for sale assets 0  
Current investments   0
Long-term    
Investments including held for sale assets 1,211  
Investments per Consolidated Balance Sheets   1,218
Total    
Investments including held for sale assets 1,211  
Total investments   1,218
Other long-term investments    
Current    
Investments including held for sale assets 0  
Current investments   0
Long-term    
Investments including held for sale assets 4,181  
Investments per Consolidated Balance Sheets   3,728
Total    
Investments including held for sale assets 4,181  
Total investments   3,728
Short-term investments    
Current    
Investments including held for sale assets 206  
Current investments   139
Long-term    
Investments including held for sale assets 0  
Investments per Consolidated Balance Sheets   0
Total    
Investments including held for sale assets $ 206  
Total investments   $ 139
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Investments - Debt Securities by Contractual Maturity Periods (Details)
$ in Millions
Dec. 31, 2023
USD ($)
Amortized Cost  
Due in one year or less, including assets held for sale $ 622
Due after one year through five years, including assets held for sale 3,914
Due after five years through ten years, including assets held for sale 3,194
Due after ten years, including assets held for sale 2,251
Mortgage and other asset-backed securities, including assets held for sale 398
Total, including assets held for sale 10,379
Fair Value  
Due in one year or less, including assets held for sale 605
Due after one year through five years, including assets held for sale 3,761
Due after five years through ten years, including assets held for sale 3,005
Due after ten years, including assets held for sale 2,119
Mortgage and other asset-backed securities, including assets held for sale 365
Total, including assets held for sale $ 9,855
v3.24.0.1
Investments - Narrative (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Schedule of Investments [Line Items]    
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
Equity securities with no readily determinable fair value 3,311 $ 484
VillageMD    
Schedule of Investments [Line Items]    
Equity securities with no readily determinable fair value $ 2,700  
Dividend 5.50%  
Value of shares for annual dividend accrual $ 2,200  
v3.24.0.1
Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
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 $ 10,379  
Allowance for Credit Loss, including held for sale assets (33)  
Unrealized Appreciation, including held for sale assets 195  
Unrealized Depreciation, including held for sale assets (686)  
Fair Value, including held for sale assets 9,855  
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 251  
Allowance for Credit Loss, including held for sale assets 0  
Unrealized Appreciation, including held for sale assets 24  
Unrealized Depreciation, including held for sale assets (8)  
Fair Value, including held for sale assets 267  
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 37  
Allowance for Credit Loss, including held for sale assets 0  
Unrealized Appreciation, including held for sale assets 2  
Unrealized Depreciation, including held for sale assets (1)  
Fair Value, including held for sale assets 38  
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 355  
Allowance for Credit Loss, including held for sale assets 0  
Unrealized Appreciation, including held for sale assets 10  
Unrealized Depreciation, including held for sale assets (13)  
Fair Value, including held for sale assets 352  
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 9,338  
Allowance for Credit Loss, including held for sale assets (33)  
Unrealized Appreciation, including held for sale assets 158  
Unrealized Depreciation, including held for sale assets (630)  
Fair Value, including held for sale assets 8,833  
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 398  
Allowance for Credit Loss, including held for sale assets 0  
Unrealized Appreciation, including held for sale assets 1  
Unrealized Depreciation, including held for sale assets (34)  
Fair Value, including held for sale assets $ 365  
v3.24.0.1
Investments - Debt Securities with a Decline in Fair Value (Details)
$ in Millions
Dec. 31, 2023
USD ($)
position
Dec. 31, 2022
USD ($)
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 $ 6,633  
Total Amortized Cost, including held for sale assets 7,319  
Total Unrealized Depreciation, including held for sale assets $ (686)  
Total Number of Issues, including held for sale assets | position 2,353  
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 $ 330  
Amortized Cost, including held for sale assets 338  
Unrealized Depreciation, including held for sale assets $ (8)  
Number of Issues, including held for sale assets | position 142  
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 $ 5,441  
Amortized Cost, including held for sale assets 6,036  
Unrealized Depreciation, including held for sale assets $ (595)  
Number of Issues, including held for sale assets | position 1,590  
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 $ 161  
Amortized Cost, including held for sale assets 170  
Unrealized Depreciation, including held for sale assets $ (9)  
Number of Issues, including held for sale assets | position 135  
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 $ 701  
Amortized Cost, including held for sale assets 775  
Unrealized Depreciation, including held for sale assets $ (74)  
Number of Issues, including held for sale assets | position 486  
v3.24.0.1
Investments - Equity Security Investments (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
 [1]
Cost      
Equity securities with readily determinable fair values $ 656 $ 673  
Equity securities with no readily determinable fair value 3,248 380  
Total 3,904 1,053  
Carrying Value      
Equity securities with readily determinable fair values 51 138  
Equity securities with no readily determinable fair value 3,311 484  
Total 3,362 622  
Other Commitments [Line Items]      
Amount funded $ 4,334 $ 2,756 [1] $ 3,553
Equity Securities FV NI | Product Concentration Risk | Health Care Sector      
Other Commitments [Line Items]      
Concentration percentage 95.00%    
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Investments - Commercial Mortgage Loan Portfolio (Details) - Real Estate Loan - Commercial Portfolio Segment
$ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss   $ 1,614
Carrying value, after allowance for credit loss, including assets held for sale $ 1,533  
Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio   1.89
Average Loan-to-Value Ratio   60.00%
Average Debt Service Coverage Ratio, including assets held for sale 1.82  
Average Loan-to-Value Ratio, including assets held for sale 0.64  
Below 60%    
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss   $ 901
Carrying value, after allowance for credit loss, including assets held for sale $ 802  
Below 60% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio   2.12
Average Debt Service Coverage Ratio, including assets held for sale 2.13  
60% to 79%    
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss   $ 564
Carrying value, after allowance for credit loss, including assets held for sale $ 574  
60% to 79% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio   1.73
Average Debt Service Coverage Ratio, including assets held for sale 1.77  
80% to 100%    
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss   $ 149
Carrying value, after allowance for credit loss, including assets held for sale $ 157  
80% to 100% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio   1.17
Average Debt Service Coverage Ratio, including assets held for sale 0.65  
v3.24.0.1
Investments - Other Long-Term Investments (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Schedule of Investments [Line Items]      
Unfunded commitments, percentage expected to fund in next fiscal year 25.00%    
Income distributions $ 253 $ 487 $ 568
Other long-term investments   3,728  
Other long term investments, including held for sale assets 4,181    
Unfunded commitments 2,797    
Real estate investments      
Schedule of Investments [Line Items]      
Other long-term investments 1,606 1,319  
Unfunded commitments 712    
Securities partnerships      
Schedule of Investments [Line Items]      
Other long-term investments 2,400 2,166  
Unfunded commitments 2,085    
Other      
Schedule of Investments [Line Items]      
Other long-term investments   $ 243  
Other long term investments, including held for sale assets 175    
Unfunded commitments $ 0    
v3.24.0.1
Investments - Summary of Derivative Instruments (Details) - Designated as Hedging Instrument - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Fair Value Hedging | Foreign currency swap contracts    
Derivative [Line Items]    
Notional Value $ 1,026 $ 1,083
Fair Value Hedging | Interest rate swap contracts    
Derivative [Line Items]    
Notional Value 1,500 1,500
Net Investment Hedging | Foreign currency swap contracts    
Derivative [Line Items]    
Notional Value $ 415 $ 460
v3.24.0.1
Investments - Components of Net Investment Income (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Net Investment Income [Line Items]      
Investment income $ 1,210 $ 1,209 $ 1,608
Less investment expenses 44 54 59
Net investment income 1,166 1,155 [1] 1,549 [1]
Debt securities      
Net Investment Income [Line Items]      
Investment income 500 572 689
Equity securities      
Net Investment Income [Line Items]      
Investment income 123 14 12
Commercial mortgage loans      
Net Investment Income [Line Items]      
Investment income 65 59 60
Policy loans      
Net Investment Income [Line Items]      
Investment income 60 59 63
Other long-term investments      
Net Investment Income [Line Items]      
Investment income 123 390 758
Short-term investments and cash      
Net Investment Income [Line Items]      
Investment income $ 339 $ 115 $ 26
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Investments - Realized Gains and Losses on Investments (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Investments [Abstract]      
Net realized investment (losses) gains, excluding credit loss expense and asset write-downs $ (68) $ (451) $ 196
Credit (loss) / recovery and other investment write-down (losses) (10) (36) 2
Net realized investment (losses) gains, before income taxes $ (78) $ (487) [1] $ 198 [1]
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Fair Value Measurements - Financial Assets and Liabilities Carried at Fair Value (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Financial assets at fair value:    
Equity securities $ 51 $ 138
Debt Securities, including held for sale assets 9,855  
Recurring    
Financial assets at fair value:    
Debt Securities   9,872
Equity securities 51 138
Short-term investments 206 139
Debt Securities, including held for sale assets 9,855  
Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 132 231
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 4 0
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities   147
Equity securities 4 6
Short-term investments 0 0
Debt Securities, including held for sale assets 130  
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 0 0
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0 0
Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities   9,278
Equity securities 47 132
Short-term investments 206 139
Debt Securities, including held for sale assets 9,278  
Significant Other Observable Inputs (Level 2) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 131 230
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 4 0
Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities   447
Equity securities 0 0
Short-term investments 0 0
Debt Securities, including held for sale assets 447  
Significant Unobservable Inputs (Level 3) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 1 1
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0 0
Federal government and agency    
Financial assets at fair value:    
Debt Securities, including held for sale assets 267  
Federal government and agency | Recurring    
Financial assets at fair value:    
Debt Securities   312
Debt Securities, including held for sale assets 267  
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 130  
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 137  
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 38  
State and local government | Recurring    
Financial assets at fair value:    
Debt Securities   41
Debt Securities, including held for sale assets 38  
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 38  
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 352  
Foreign government | Recurring    
Financial assets at fair value:    
Debt Securities   365
Debt Securities, including held for sale assets 352  
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 352  
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities   0
Debt Securities, including held for sale assets 0  
Corporate    
Financial assets at fair value:    
Debt Securities, including held for sale assets 8,833  
Corporate | Recurring    
Financial assets at fair value:    
Debt Securities   8,806
Debt Securities, including held for sale assets 8,833  
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 8,432  
Corporate | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities   412
Debt Securities, including held for sale assets 401  
Mortgage and other asset-backed    
Financial assets at fair value:    
Debt Securities, including held for sale assets 365  
Mortgage and other asset-backed | Recurring    
Financial assets at fair value:    
Debt Securities   348
Debt Securities, including held for sale assets 365  
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 319  
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 $ 46  
v3.24.0.1
Fair Value Measurements - Narrative (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Percent of debt and equity securities classified in Level 2, including assets held for sale 94.00%  
Percent of debt and equity securities classified in Level 3, including assets held for sale 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    
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 0
Adjustment for credit risk on derivatives liabilities $ 0 $ 0
v3.24.0.1
Fair Value Measurements - Quantitative Information About Unobservable Inputs (Details) - Recurring - Significant Unobservable Inputs (Level 3)
$ in Millions
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Debt securities    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value   $ 447
Fair Value, including held for sale assets $ 447  
Corporate | Securities Priced by the Company    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value   $ 412
Fair Value, including held for sale assets $ 401  
Corporate | 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 0.0070  
Corporate | 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 0.1235  
Corporate | Securities Priced by the Company | Weighted Average | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment   0.0270
Unobservable Adjustment, including held for sale assets 0.0310  
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 $ 46  
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 0.0095  
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 0.0640  
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 0.0310  
v3.24.0.1
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, 2023
Dec. 31, 2022
Transfers into/(out of) Level 3    
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period $ 3 $ (60)
Debt and Equity Securities    
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance 447  
Beginning balance, including held for sale assets   796
(Losses) gains included in Shareholders' net income (2) 11
Gains (losses) included in Other comprehensive loss 8 (59)
Purchases, sales and settlements    
Purchases 10 158
Settlements (52) (207)
Total purchases, sales and settlements (42) (49)
Transfers into/(out of) Level 3    
Transfers into Level 3 95 124
Transfers out of Level 3 (59) (376)
Total transfers into/(out of) Level 3 36 (252)
Ending balance   447
Ending balance, including held for sale assets 447  
Total losses included in Shareholders' net income attributable to instruments held at the reporting date $ (2) $ (2)
v3.24.0.1
Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts $ 578 $ 585
Non-guaranteed separate accounts 6,172 5,936
Subtotal 6,750 6,521
Non-guaranteed separate accounts priced at NAV as a practical expedient 680 757
Separate account assets 7,430 7,278 [1]
Pension Plans    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Non-guaranteed separate accounts 4,000 4,000
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 226 203
Non-guaranteed separate accounts 158 211
Subtotal 384 414
Significant Other Observable Inputs (Level 2)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts 352 382
Non-guaranteed separate accounts 5,797 5,522
Subtotal 6,149 5,904
Significant Unobservable Inputs (Level 3)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts 0 0
Non-guaranteed separate accounts 217 203
Subtotal 217 203
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 $ 200
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
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, 2023
Dec. 31, 2022
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments $ 254  
Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value 680 $ 757
Securities partnerships    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments 254  
Securities partnerships | Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value 419 451
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 $ 258 302
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 $ 3 $ 4
v3.24.0.1
Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Realized investment losses on assets measured at fair value under certain conditions, after-tax
Realized investment gains on equity securities with no readily determinable fair value
v3.24.0.1
Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
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 $ 28,033 $ 28,653
Fair Value | Significant Unobservable Inputs (Level 3)    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Commercial mortgage loans   1,491
Commercial mortgage loans, including assets held for sale 1,430  
Carrying Value    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Commercial mortgage loans   1,614
Long-term debt, including current maturities, excluding finance leases 29,585 $ 30,994
Commercial mortgage loans, including assets held for sale $ 1,533  
v3.24.0.1
Variable Interest Entities (Details)
$ in Millions
Dec. 31, 2023
USD ($)
limitedPartnership
entity
Dec. 31, 2022
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 190  
VIEs, Carrying value $ 2,900  
Maximum exposure to loss, variable interest entities 5,500  
Variable Interest Entity, Not Primary Beneficiary | Real estate joint ventures    
Variable Interest Entity [Line Items]    
Maximum exposure to loss, variable interest entities 900  
Guaranty liability 0  
Maximum guarantee exposure 488  
Variable Interest Entity, Not Primary Beneficiary | Asset-backed and corporate securities    
Variable Interest Entity [Line Items]    
Maximum exposure to loss, variable interest entities 500  
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 8.00%  
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 $ 2,600  
v3.24.0.1
Collectively Significant Operating Unconsolidated Subsidiaries (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Equity Method Investment, Summarized Financial Information [Abstract]      
Loss related to unconsolidated entities reported on the equity method $ 1,864 $ 1,658 [1]  
Income Statement [Abstract]      
Revenues 195,265 180,518 [1] $ 174,069 [1]
Net income 5,372 6,782 [1] 5,420 [1]
Balance Sheet [Abstract]      
Total assets 152,761 143,885 [1]  
Total liabilities 106,410 99,131 [1]  
Operating joint ventures      
Equity Method Investment, Summarized Financial Information [Abstract]      
Equity method investments, carrying value 911 734  
Loss related to unconsolidated entities reported on the equity method 510 88  
Operating joint ventures | China      
Equity Method Investment, Summarized Financial Information [Abstract]      
Equity method investments, carrying value 214 602  
Operating joint ventures      
Income Statement [Abstract]      
Revenues 5,962 4,665 3,750
Net income 98 (12) $ 180
Balance Sheet [Abstract]      
Total assets 26,681 21,026  
Total liabilities $ 25,534 $ 19,462  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Accumulated Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance $ 44,688 [1] $ 46,976 $ 50,189
Other comprehensive loss, net of tax (206) (592) [1] (57) [1]
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests 0 (2) [1] (14) [1]
Shareholders other comprehensive income (loss), net of tax (206) (590) (43)
Balance 46,244 44,688 [1] 46,976
Previously Reported      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     50,328
Revision of Prior Period, Accounting Standards Update, Adjustment      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     (139)
Accumulated Other Comprehensive (Loss)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (1,658) (1,068) (1,025)
Shareholders other comprehensive income (loss), net of tax (206) (590) (43)
Balance (1,864) (1,658) (1,068)
Accumulated Other Comprehensive (Loss) | Previously Reported      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     (861)
Accumulated Other Comprehensive (Loss) | Revision of Prior Period, Accounting Standards Update, Adjustment      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     (164)
Securities and Derivatives      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (332) 1,266 1,568
Other comprehensive income (loss) before reclassifications, before tax 620 (2,274) (335)
Other comprehensive income (loss), before reclassifications, tax (146) 467 52
Other comprehensive income (loss) before reclassifications, after-tax 474 (1,807) (283)
Reclassification adjustment, tax (8) (10) 5
Net amounts reclassified from AOCI to net income 29 209 (19)
Shareholders other comprehensive income (loss), net of tax 503 (1,598) (302)
Balance 171 (332) 1,266
Securities and Derivatives | Previously Reported      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     900
Securities and Derivatives | Revision of Prior Period, Accounting Standards Update, Adjustment      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     668
AOCI, Accumulated Gain (Loss), Debt Securities, Available-For-Sale And Derivatives, (Gain) Loss On Sale Of Business, Parent      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax 0 172 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 38 47 (24)
Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax (1) 0 0
Net long-duration insurance and contractholder liabilities measurement adjustments (1)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (256) (765) (832)
Shareholders other comprehensive income (loss), net of tax (715) 509 67
Balance (971) (256) (765)
Net long-duration insurance and contractholder liabilities measurement adjustments (1) | Previously Reported      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     0
Net long-duration insurance and contractholder liabilities measurement adjustments (1) | Revision of Prior Period, Accounting Standards Update, Adjustment      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance     (832)
Current period change in discount rate for certain long-duration liabilities      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Other comprehensive income (loss) before reclassifications, before tax (913) 642 59
Other comprehensive income (loss), before reclassifications, tax 222 (122) (3)
Other comprehensive income (loss) before reclassifications, after-tax (691) 520 56
Current period change in instrument-specific credit risk for market risk benefits      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Other comprehensive income (loss) before reclassifications, before tax (29) (14) 13
Other comprehensive income (loss), before reclassifications, tax 5 3 (2)
Other comprehensive income (loss) before reclassifications, after-tax (24) (11) 11
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 0 (277) (213)
Other comprehensive income (loss) including temporary equity, before reclassifications, tax 5 (33) (19)
Other comprehensive income (loss) including temporary equity, before reclassifications, after-tax 5 (310) (232)
Reclassification adjustment, before tax 0 358 0
Reclassification adjustment, tax 0 29 0
Net amounts reclassified from AOCI to net income 0 387 0
Translation of foreign currencies, before tax 0 81 (213)
Other Comprehensive Income (Loss), Tax, Including Temporary Equity 5 (4) (19)
Other comprehensive loss, net of tax 5 77 (232)
Translation of foreign currencies attributable to parent      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (154) (233) (15)
Shareholders other comprehensive income (loss), net of tax 5 79 (218)
Balance (149) (154) (233)
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 0 (2) (14)
Postretirement benefits liability      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Balance (916) (1,336) (1,746)
Other comprehensive income (loss) before reclassifications, before tax (46) 487 448
Other comprehensive income (loss), before reclassifications, tax 12 (115) (106)
Other comprehensive income (loss) before reclassifications, after-tax (34) 372 342
Reclassification adjustment, tax (11) (16) (21)
Net amounts reclassified from AOCI to net income 35 48 68
Shareholders other comprehensive income (loss), net of tax 1 420 410
Balance (915) (916) (1,336)
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 46 65 85
Reclassification adjustment for (gains) included in Shareholders' net income ((Loss) gain on sale of businesses)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax 0 (1) 0
Reclassification adjustment for settlement (Interest expense and other)      
Accumulated Other Comprehensive Income (Loss) [Line Items]      
Reclassification adjustment, before tax $ 0 $ 0 $ 4
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Organizational Efficiency Plan (Details) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Dec. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Restructuring and Related Activities [Abstract]        
One-time expenses related to abandonment of leased assets and impairment of property and equipment $ 20      
Charge for organizational efficiency plan recorded in Selling, general and administrative expenses, pre-tax 252 $ 252 $ 22 $ 168
Charge for organizational efficiency plan recorded in Selling, general and administrative expenses, after-tax 193 193 17 $ 119
Restructuring Reserve [Roll Forward]        
Restructuring Reserve, Beginning Balance   0    
Severance Costs 232      
Payments (30)      
Restructuring Reserve, Ending Balance $ 202 $ 202 $ 0  
v3.24.0.1
Pension - Narrative (Details) - USD ($)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
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 4,000,000,000    
Plan assets 4,138,000,000 $ 4,186,000,000 $ 4,846,000,000
Contributions to qualifed pension plans 0 $ 2,000,000  
Plan assets invested in separate accounts of subsidiaries 4,000,000,000    
Plan assets invested in funds offered by an unaffiliated insurance company 100,000,000    
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    
v3.24.0.1
Pension - Projected Benefit Obligations and Assets (Details) - Pension Plans - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Change in benefit obligation      
Benefit obligation, January 1 $ 3,948 $ 5,223  
Service cost 1 2 $ 2
Interest cost 204 140 132
Actuarial (gains), net 93 (1,094)  
Benefits paid from plan assets (294) (296)  
Other (18) (27)  
Benefit obligation, December 31 3,934 3,948 5,223
Change in plan assets      
Fair value of plan assets, January 1 4,186 4,846  
Actual return on plan assets 246 (366)  
Benefits paid (294) (296)  
Contributions 0 2  
Fair value of plan assets, December 31 4,138 4,186 $ 4,846
Funded status 204 238  
Amounts presented in Consolidated Balance Sheets      
Other assets $ 204 $ 238  
v3.24.0.1
Pension - Benefit Payments (Details) - Pension Plans
$ in Millions
Dec. 31, 2023
USD ($)
Benefit payments including expected future services [Abstract]  
2024 $ 319
2025 316
2026 317
2027 314
2028 311
2029 - 2033 $ 1,484
v3.24.0.1
Pension - Amounts Included in Accumulated Other Comprehensive Income (Details) - Pension Plans - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Defined Benefit Plan Disclosure [Line Items]    
Unrecognized net (losses) $ (1,207) $ (1,208)
Unrecognized prior service cost (4) (5)
Postretirement benefits liability adjustment $ (1,211) $ (1,213)
v3.24.0.1
Pension - Net Pension Cost (Details) - Pension Plans - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Defined Benefit Plan, Net Periodic Benefit Cost (Credit) [Abstract]      
Service cost $ 1 $ 2 $ 2
Interest cost 204 140 132
Expected long-term return on plan assets (204) (272) (269)
Amortization of:      
Prior actuarial losses, net 52 89 78
Settlement loss 0 0 4
Net (benefit) cost $ 53 $ (41) $ (53)
v3.24.0.1
Pension - Assumptions Used for Pension (Details) - Pension Plans
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Discount rate:    
Pension benefit obligation 5.10% 5.43%
Pension benefit cost 5.43% 2.82%
Expected long-term return on plan assets:    
Pension benefit cost 6.50% 6.75%
v3.24.0.1
Pension - Pension Plan Assets (Details) - Pension Plans - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 4,138 $ 4,186 $ 4,846
Debt securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 3,191 2,947  
Target allocation percentages 90.00%    
Federal government securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 12 11  
Corporate securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 2,780 2,349  
Mortgage and other asset-backed      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 121 109  
Fund investments      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 278 478  
Other investments      
Defined Benefit Plan Disclosure [Line Items]      
Target allocation percentages 10.00%    
Equity securities      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 33 124  
Domestic      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 27 89  
International, including funds and pooled separate accounts      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 6 35  
Securities partnerships      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 419 452  
Real estate funds, including pooled separate accounts      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 270 315  
Commercial mortgage loans      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 46 63  
Guaranteed deposit account contract      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value 48 50  
Cash equivalents and other current assets, net      
Defined Benefit Plan Disclosure [Line Items]      
Pension assets at fair value $ 131 $ 235  
v3.24.0.1
Pension - Annual Expense for 401(k) Plans (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Retirement Benefits [Abstract]      
Expense $ 296 $ 274 $ 268
v3.24.0.1
Employee Incentive Plans - Shares of Common Stock Available for Award (Details) - shares
shares in Millions
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]      
Common shares available for award (in shares) 14.4 16.6 19.1
v3.24.0.1
Employee Incentive Plans - Narrative (Details)
$ / shares in Units, shares in Thousands, $ in Millions
 12 Months Ended
Dec. 31, 2023
USD ($)
employee
$ / shares
shares
Dec. 31, 2022
$ / shares
shares
Dec. 31, 2021
$ / shares
shares
Dec. 31, 2020
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 $ 67      
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 $ 196      
Period over which compensation expense will be recognized 2 years      
Number of employees holding share-based payment awards | employee 8,900      
Awards outstanding (in shares) | shares 1,404 1,535 1,524 1,600
SPSs        
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]        
Compensation expense to be recognized $ 61      
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 $ 329.11 $ 258.37 $ 239.57  
Number of employees holding share-based payment awards | employee 600      
Awards outstanding (in shares) | shares 686 780 860 808
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%      
v3.24.0.1
Employee Incentive Plans - Black-Scholes Option-Pricing Model Assumptions (Details) - Employee Stock Options - $ / shares
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Dividend yield 1.58% 1.98% 1.85%
Expected volatility 30.00% 30.00% 30.00%
Risk-free interest rate 3.60% 1.60% 0.50%
Expected option life 4 years 8 months 12 days 4 years 6 months 4 years 6 months
Weighted average fair value of options (in dollars per share) $ 79.66 $ 50.61 $ 44.84
v3.24.0.1
Employee Incentive Plans - Status of and Changes in Common Stock Options (Details) - Employee Stock Options - $ / shares
shares in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Options      
Outstanding - January 1 (in shares) 6,992 8,490 9,742
Granted (in shares) 915 1,375 1,524
Exercised (in shares) (1,080) (2,617) (2,584)
Expired or canceled (in shares) (131) (256) (192)
Options outstanding - December 31 (in shares) 6,696 6,992 8,490
Options exercisable at year-end (in shares) 4,616 4,410 5,612
Weighted Average Exercise Price      
Outstanding - January 1 (in dollars per share) $ 186.54 $ 169.47 $ 152.40
Granted (in dollars per share) 294.37 226.95 213.81
Exercised (in dollars per share) 174.66 149.97 129.08
Expired or canceled (in dollars per share) 246.95 211.22 199.10
Outstanding - December 31 (in dollars per share) 202.02 186.54 169.47
Options exercisable at year-end (in dollars per share) $ 179.28 $ 168.97 $ 152.92
v3.24.0.1
Employee Incentive Plans - Summary of Information for Stock Options Exercised (Details) - Employee Stock Options - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Intrinsic value of options exercised $ 126 $ 313 $ 268
Cash received for options exercised 187 389 326
Tax benefit from options exercised $ 17 $ 47 $ 50
v3.24.0.1
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, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Options Outstanding        
Number (in shares) 6,696 6,992 8,490 9,742
Total intrinsic value $ 652      
Weighted average exercise price (in dollars per share) $ 202.02 $ 186.54 $ 169.47 $ 152.40
Weighted average remaining contractual life 5 years 10 months 24 days      
Options Exercisable        
Number (in shares) 4,616 4,410 5,612  
Total intrinsic value $ 555      
Weighted average exercise price (in dollars per share) $ 179.28 $ 168.97 $ 152.92  
Weighted average remaining contractual life 4 years 8 months 12 days      
v3.24.0.1
Employee Incentive Plans - Status of and Changes in Restricted Stock Awards and SPSs (Details) - $ / shares
shares in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Restricted Stock Grants and Units      
Grants/Units      
Outstanding - January 1 (in shares) 1,535 1,524 1,600
Awarded (in shares) 700 876 899
Vested (in shares) (759) (714) (866)
Forfeited (in shares) (72) (151) (109)
Outstanding - December 31 (in shares) 1,404 1,535 1,524
Weighted Average Fair Value at Award Date      
Outstanding - January 1 (in dollars per share) $ 219.25 $ 202.85 $ 186.12
Awarded (in dollars per share) 294.60 229.60 213.82
Vested (in dollars per share) 214.70 197.83 184.07
Forfeited (in dollars per share) 256.24 215.02 197.01
Outstanding - December 31 (in dollars per share) $ 257.38 $ 219.25 $ 202.85
SPSs      
Grants/Units      
Outstanding - January 1 (in shares) 780 860 808
Awarded (in shares) 219 294 331
Vested (in shares) (250) (261) (206)
Forfeited (in shares) (63) (113) (73)
Outstanding - December 31 (in shares) 686 780 860
Weighted Average Fair Value at Award Date      
Outstanding - January 1 (in dollars per share) $ 212.68 $ 197.07 $ 190.02
Awarded (in dollars per share) 293.85 230.69 213.90
Vested (in dollars per share) 191.78 183.60 196.29
Forfeited (in dollars per share) 237.50 207.75 197.38
Outstanding - December 31 (in dollars per share) $ 243.90 $ 212.68 $ 197.07
v3.24.0.1
Employee Incentive Plans - Fair Value of Vested Restricted Stock and SPSs (Details) - USD ($)
shares in Thousands, $ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Restricted Stock Grants and Units      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Fair value of vested shares $ 220 $ 167 $ 183
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) 257 137 243
Fair value of vested shares $ 76 $ 31 $ 51
v3.24.0.1
Employee Incentive Plans - Compensation Cost and Tax Effects of Share-based Compensation (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]      
Total compensation cost for shared-based awards $ 286 $ 264 $ 268
Tax benefits recognized $ 92 $ 80 $ 73
v3.24.0.1
Goodwill, Other Intangibles and Property and Equipment - Narrative (Details) - USD ($)
$ in Billions
Dec. 31, 2023
Dec. 31, 2022
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]    
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 and 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  
Purchased and internally developed software | Maximum    
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]    
Estimated useful life, property, plant and equipment 5 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  
Leasehold Improvements    
Schedule Of Goodwill, Other Intangible Assets And Property, Plant And Equipment [Line Items]    
Estimated useful life, leasehold improvements Useful Life, Shorter of Lease Term or Asset Utility [Member]  
v3.24.0.1
Goodwill, Other Intangibles, and Property and Equipment - Goodwill Activity (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Goodwill [Roll Forward]      
Balance at January 1 [1] $ 45,811    
Balance at January 1, including held for sale assets   $ 46,045  
Goodwill disposed   (234)  
Goodwill transferred to assets of businesses held for sale (1,553)    
Impact of foreign currency translation and other adjustments 1 0  
Balance at December 31 44,259 45,811 [1]  
Held-for-Sale | International life, accident and supplemental benefits businesses      
Goodwill [Roll Forward]      
Goodwill classified as Assets of businesses held for sale     $ 234
Evernorth Health Services      
Goodwill [Roll Forward]      
Balance at January 1 35,130    
Balance at January 1, including held for sale assets   35,128  
Goodwill disposed   0  
Goodwill transferred to assets of businesses held for sale 0    
Impact of foreign currency translation and other adjustments 0 2  
Balance at December 31 35,130 35,130  
Cigna Healthcare      
Goodwill [Roll Forward]      
Balance at January 1 10,681    
Balance at January 1, including held for sale assets   10,683  
Goodwill disposed   0  
Goodwill transferred to assets of businesses held for sale (1,553)    
Impact of foreign currency translation and other adjustments 1 (2)  
Balance at December 31 9,129 10,681  
Other Operations      
Goodwill [Roll Forward]      
Balance at January 1 0    
Balance at January 1, including held for sale assets   234  
Goodwill disposed   (234)  
Goodwill transferred to assets of businesses held for sale 0    
Impact of foreign currency translation and other adjustments 0 0  
Balance at December 31 $ 0 $ 0  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Goodwill, Other Intangibles, and Property and Equipment - Other Intangible Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Finite-lived intangible assets    
Accumulated Amortization   $ 6,230
Accumulated Amortization, including held for sale assets $ 7,755  
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 30,863 32,492 [1]
Cost, including held for sale assets 38,695  
Net Carrying Value, including held for sale assets 30,940  
Value of business acquired ("VOBA" reported in Other assets)    
Cost   210
Accumulated Amortization   133
Net Carrying Value   77
Cost, including held for sale assets 211  
Accumulated Amortization, including held for sale assets 142  
Net Carrying Value, including held for sale assets 69  
Total    
Cost   38,932
Accumulated Amortization   6,363
Net Carrying Value   32,569
Cost, including held for sale assets 38,906  
Accumulated Amortization, including held for sale assets 7,897  
Net Carrying Value, including held for sale assets 31,009  
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Total    
VOBA, held for sale 69  
Other intangible assets, held for sale 77  
Customer relationships    
Finite-lived intangible assets    
Cost   29,974
Accumulated Amortization   6,099
Net Carrying Value   23,875
Cost, including held for sale assets 29,978  
Accumulated Amortization, including held for sale assets 7,645  
Net Carrying Value, including held for sale assets 22,333  
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 110  
Other intangible assets    
Cost   348
Net Carrying Value   $ 217
Cost, including held for sale assets 317  
Net Carrying Value, including held for sale assets $ 207  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Goodwill, Other Intangibles, and Property and Equipment - Property and Equipment (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Property and equipment, including held for sale assets    
Cost $ 12,437  
Accumulated Amortization 8,566  
Net Carrying Value 3,871  
Total property and equipment    
Cost   $ 11,204
Accumulated amortization   7,430
Net carrying value   3,774
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Property and equipment classified as Assets of businesses held for sale    
Property and equipment, net carrying value classified as assets of business held for sale 176  
Internal-use software    
Property and equipment, including held for sale assets    
Cost 10,155  
Accumulated Amortization 7,161  
Net Carrying Value 2,994  
Total property and equipment    
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 2,282  
Accumulated Amortization 1,405  
Net Carrying Value $ 877  
Total property and equipment    
Cost   2,256
Accumulated amortization   1,330
Net carrying value   $ 926
v3.24.0.1
Goodwill, Other Intangibles, and Property and Equipment - Components of Depreciation and Amortization Expense (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization $ 3,035 $ 2,937 [1] $ 2,923 [1]
Internal-use software      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization 1,216 1,068 1,097
Other property and equipment      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization 260 251 253
Value of business acquired (reported in Other assets)      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization 7 12 25
Other intangibles      
Depreciation And Amortization By Type [Line Items]      
Depreciation and amortization $ 1,552 $ 1,606 $ 1,548
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Goodwill, Other Intangibles, and Property and Equipment - Estimated Annual Pre-Tax Amortization for Intangible Assets (Details)
$ in Millions
Dec. 31, 2023
USD ($)
Goodwill Other Intangibles And Property And Equipment [Abstract]  
2024 $ 2,892
2025 2,357
2026 1,803
2027 1,559
2028 $ 1,484
v3.24.0.1
Leases - Narrative (Details)
Dec. 31, 2023
Lessee, Lease, Description [Line Items]  
Weighted average remaining lease term for operating leases 6 years
Weighted average remaining lease term for finance leases 3 years
Weighted average discount rate for operating leases 3.45%
Weighted average discount rate for finance leases 4.29%
Maximum  
Lessee, Lease, Description [Line Items]  
Term length for operating leases 35 years
v3.24.0.1
Leases - Components of Lease Expense (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Leases [Abstract]      
Operating lease cost $ 115 $ 124 $ 170
Finance lease cost:      
Amortization of ROU assets 41 33 22
Interest on lease liabilities 4 2 2
Total finance lease cost 45 35 24
Variable lease cost 38 41 39
Total lease cost $ 198 $ 200 $ 233
v3.24.0.1
Leases - Supplemental Cash Flow Information Related to Leases (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:      
Operating cash outflows from operating leases $ 132 $ 148 $ 167
Operating cash outflows from finance leases 4 2 2
Financing cash outflows from finance leases 39 33 22
ROU assets obtained in exchange for lease obligations:      
Operating leases 103 43 122
Finance leases $ 48 $ 84 $ 20
v3.24.0.1
Leases - Operating and Finance Lease Right of Use ("ROU") Assets and Lease Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Operating leases:    
Operating lease ROU assets $ 370 $ 375
Accrued expenses and other liabilities 105 114
Other non-current liabilities 340 346
Total operating lease liabilities 445 460
Finance leases:    
Property and equipment, gross 177 145
Accumulated depreciation (73) (48)
Property and equipment, net 104 97
Short-term debt 42 33
Long-term debt 66 66
Total finance lease liabilities $ 108 $ 99
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
v3.24.0.1
Leases - Maturities of Lease Liabilities (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Operating Leases    
2024 $ 110  
2025 102  
2026 83  
2027 63  
2028 41  
Thereafter 98  
Total lease payments 497  
Less: imputed interest 52  
Total 445 $ 460
Finance Leases    
2024 46  
2025 38  
2026 19  
2027 6  
2028 6  
Thereafter 0  
Total lease payments 115  
Less: imputed interest 7  
Total $ 108 $ 99
v3.24.0.1
Shareholders Equity and Dividend Restrictions (Details) - USD ($)
$ in Billions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Equity [Abstract]      
Net income $ 5.3 $ 5.7 $ 3.4
Surplus 14.9 $ 16.4 $ 13.3
Minimum statutory surplus required by regulators 4.8    
Investments on deposit with regulatory bodies 0.3    
Maximum dividend distributions permitted in 2024 without regulatory approval 2.1    
Maximum loans to the parent company permitted without regulatory approval 1.4    
Restricted GAAP net assets of The Cigna Group's subsidiaries 12.3    
Undistributed earnings from equity method subidiaries $ 1.0    
v3.24.0.1
Income Taxes - Components of Income Taxes (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Current taxes      
U.S. income taxes $ 1,459 $ 1,679 $ 1,267
Foreign income taxes 161 219 207
State income taxes 180 189 112
Total current taxes 1,800 2,087 1,586
Deferred taxes (benefits)      
U.S. income tax benefits (533) (275) (163)
Foreign income (tax benefits) taxes (1,046) (28) 69
State income tax benefits (80) (169) (122)
Total deferred tax benefits (1,659) (472) (216)
Total income taxes $ 141 $ 1,615 [1] $ 1,370 [1]
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Income Taxes - Nominal Tax Rate Reconciliation (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
$      
Tax expense at nominal rate $ 1,158 $ 1,763 $ 1,426
Effect of foreign earnings (173) (96) (33)
State income tax (benefit), net of federal income tax benefit (39) 16 (9)
Swiss tax attributes (1,674) 0 0
Other foreign tax attributes (153) 0 0
Change in valuation allowance 1,290 0 0
Other (55) (31) (14)
Total income taxes $ 141 $ 1,615 [1] $ 1,370 [1]
%      
Tax expense at nominal rate 21.00% 21.00% 21.00%
Effect of foreign earnings (3.10%) (1.20%) (0.50%)
State income tax (benefit), net of federal income tax benefit (0.70%) 0.20% (0.10%)
Swiss tax attributes (30.40%) 0.00% 0.00%
Other foreign tax attributes (2.80%) 0.00% 0.00%
Change in valuation allowance 23.40% 0.00% 0.00%
Other (0.90%) (0.40%) (0.20%)
Total income taxes 2.60% 19.20% 20.20%
Disposed of by Sale | International life, accident and supplemental benefits businesses      
$      
Impact of sale of businesses $ 0 $ (37) $ 0
%      
Impact of sale of businesses 0.00% (0.40%) 0.00%
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses      
$      
Impact of sale of businesses $ (213) $ 0 $ 0
%      
Impact of sale of businesses (3.90%) 0.00% 0.00%
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Income Taxes - Pre-tax Income From Foreign Operations (Details)
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Pre-Tax Income | Geographic Concentration Risk | Foreign      
Concentration Risk [Line Items]      
Concentration percentage 48.00% 46.00% 26.00%
v3.24.0.1
Income Taxes - Foreign Jurisdiction Tax Attributes and Sale of Medicare Advantage and Related Businesses (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Income Tax Disclosure [Abstract]    
Deferred tax assets associated with foreign tax attributes $ 1,800 $ 0
Valuation allowance against deferred tax assets associated with foreign tax attributes 772  
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]    
Deferred loss - sale of business 584 0
Valuation allowance   $ 208
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]    
Deferred loss - sale of business 584  
Valuation allowance $ 584  
v3.24.0.1
Income Taxes - Deferred Income Taxes (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Deferred tax assets    
Employee and retiree benefit plans   $ 189
Other insurance and contractholder liabilities   278
Loss carryforwards   205
Deferred loss - sale of business $ 584 0
Other accrued liabilities   265
Policy acquisition expenses   36
Unrealized depreciation on investments and foreign currency translation   159
Foreign tax attributes 1,800 0
Other   190
Deferred tax assets before valuation allowance   1,322
Valuation allowance for deferred tax assets   (208)
Deferred tax assets, net of valuation allowance   1,114
Deferred tax assets, including held for sale assets    
Employee and retiree benefit plans 217  
Other insurance and contractholder liabilities 353  
Loss carryforwards 200  
Deferred loss - sale of business 584 0
Other accrued liabilities 244  
Policy acquisition expenses 39  
Unrealized depreciation on investments and foreign currency translation 81  
Foreign tax attributes 1,827  
Other 242  
Deferred tax assets before valuation allowance 3,787  
Valuation allowance for deferred tax assets (1,498)  
Deferred tax assets, net of valuation allowance 2,289  
Deferred tax liabilities    
Depreciation and amortization   512
Acquisition-related basis differences   8,347
Other   41
Total deferred tax liabilities   8,900
Deferred tax liabilities, including held for sale liabilities    
Depreciation and amortization 371  
Acquisition-related basis differences 8,105  
Other 0  
Total deferred tax liabilities 8,476  
Deferred tax liabilities, net, including amounts reported in Liabilities of businesses held for sale (6,187)  
Net deferred income tax liabilities(1)   $ (7,786)
Deferred tax assets reported in Other Assets 1,055  
Deferred tax assets associated with unrealized investment losses 218  
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Deferred tax assets    
Deferred loss - sale of business 584  
Valuation allowance for deferred tax assets (584)  
Deferred tax assets, including held for sale assets    
Deferred loss - sale of business 584  
Deferred tax liabilities, including held for sale liabilities    
Net deferred income tax liabilities classified as liabilities of businesses held for sale $ 69  
v3.24.0.1
Income Taxes - Uncertain Tax Positions (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]      
Balance at January 1, $ 1,343 $ 1,230 $ 1,210
(Decrease) / Increase due to prior year positions   8 21
(Decrease) due to prior year tax positions (26)    
Increase due to current year positions 107 137 31
Reduction related to settlements with taxing authorities (13) (4) (15)
Reduction related to lapse of applicable statute of limitations (12) (28) (17)
Balance at December 31, 1,399 1,343 1,230
Liability for net interest expense on uncertain tax positions $ 220 $ 176 $ 148
v3.24.0.1
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, 2023
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     $ 150,000,000 100,000,000
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
v3.24.0.1
Segment Information - Summary of Special Items (Details) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Dec. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Pre-tax        
(Gain) loss on sale of business   $ 1,499 $ (1,662) $ 0
Charge for organizational efficiency plan (Selling, general and administrative expenses) $ 252 252 22 168
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)   201 (28) (27)
Integration and transaction-related costs, pre-tax   45 135 169
Deferred tax (benefits), net (Income taxes, less amount attributable to noncontrolling interests)   0 0 0
Debt extinguishment costs   0 0 141
Total impact from special items   1,997 (1,533) 451
After-tax        
(Gain) loss on sale of business, after-tax   1,429 (1,332) 0
Charge for organizational efficiency plan, after-tax (Selling, general and administrative expenses) $ 193 193 17 119
(Benefits) charges associated with litigation matters, after-tax (Selling, general and administrative expenses)   171 (20) (21)
Integration and transaction-related costs, after-tax (Selling, general and administrative expenses)   35 103 71
Deferred tax (benefits), net, after-tax (Income taxes, less amount attributable to noncontrolling interests)   (1,071) 0 0
Debt extinguishment costs, after-tax   0 0 110
Total impact from special items   $ 757 $ (1,232) $ 279
v3.24.0.1
Segment Information - Summarized Segment Financial Information (Details) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Dec. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Segment Reporting Information [Line Items]        
Revenues from customers   $ 194,099 $ 179,363 $ 172,520
Net investment income (loss)   1,166 1,155 [1] 1,549 [1]
TOTAL REVENUES   195,265 180,518 [1] 174,069 [1]
Net realized investment results from certain equity method investments   57 126 0
Adjusted revenues   195,322 180,644 174,069
Depreciation and amortization   3,035 2,937 [1] 2,923 [1]
Income before income taxes   5,513 8,397 [1] 6,790 [1]
Pre-tax adjustments to reconcile to adjusted income from operations        
(Income) loss attributable to noncontrolling interests   (146) (84) (58)
Net realized investment (gains) losses   135 613 (198)
Amortization of acquired intangible assets   1,819 1,876 [1] 1,998 [1]
Special items        
(Gain) loss on sale of business   1,499 (1,662) 0
Charge for organizational efficiency plan $ 252 252 22 168
(Benefits) charges associated with litigation matters   201 (28) (27)
Integration and transaction-related costs   45 135 169
Debt extinguishment costs   0 0 141
Pre-tax adjusted income (loss) from operations   9,318 9,269 8,983
Evernorth Health Services        
Segment Reporting Information [Line Items]        
Revenues from customers   147,588 135,786 127,692
Cigna Healthcare        
Segment Reporting Information [Line Items]        
Revenues from customers   46,219 41,738 41,369
Other Operations        
Segment Reporting Information [Line Items]        
Revenues from customers   291 1,839 3,459
Operating Segments | Evernorth Health Services        
Segment Reporting Information [Line Items]        
Net investment income (loss)   241 86 17
TOTAL REVENUES   153,499 140,335 131,912
Net realized investment results from certain equity method investments   0 0 0
Adjusted revenues   153,499 140,335 131,912
Depreciation and amortization   2,438 2,283 2,316
Income before income taxes   4,768 4,421 3,908
Pre-tax adjustments to reconcile to adjusted income from operations        
(Income) loss attributable to noncontrolling interests   (144) (66) (31)
Net realized investment (gains) losses   0 0 4
Amortization of acquired intangible assets   1,774 1,772 1,937
Special items        
(Gain) loss on sale of business   0 0  
Charge for organizational efficiency plan   0 0 0
(Benefits) charges associated with litigation matters   44 0 0
Integration and transaction-related costs   0 0 0
Debt extinguishment costs       0
Pre-tax adjusted income (loss) from operations   6,442 6,127 5,818
Operating Segments | Cigna Healthcare        
Segment Reporting Information [Line Items]        
Net investment income (loss)   597 638 1,003
TOTAL REVENUES   51,148 44,911 44,643
Net realized investment results from certain equity method investments   57 126 0
Adjusted revenues   51,205 45,037 44,643
Depreciation and amortization   569 638 551
Income before income taxes   2,664 3,470 3,804
Pre-tax adjustments to reconcile to adjusted income from operations        
(Income) loss attributable to noncontrolling interests   (2) (4) (3)
Net realized investment (gains) losses   133 530 (247)
Amortization of acquired intangible assets   45 103 47
Special items        
(Gain) loss on sale of business   1,481 0  
Charge for organizational efficiency plan   0 0 0
(Benefits) charges associated with litigation matters   157 0 0
Integration and transaction-related costs   0 0 0
Debt extinguishment costs       0
Pre-tax adjusted income (loss) from operations   4,478 4,099 3,601
Operating Segments | Other Operations        
Segment Reporting Information [Line Items]        
Net investment income (loss)   305 424 530
TOTAL REVENUES   596 2,263 3,989
Net realized investment results from certain equity method investments   0 0 0
Adjusted revenues   596 2,263 3,989
Depreciation and amortization   3 6 52
Income before income taxes   76 2,101 868
Pre-tax adjustments to reconcile to adjusted income from operations        
(Income) loss attributable to noncontrolling interests   0 (14) (24)
Net realized investment (gains) losses   2 83 45
Amortization of acquired intangible assets   0 1 14
Special items        
(Gain) loss on sale of business   18 (1,662)  
Charge for organizational efficiency plan   0 0 0
(Benefits) charges associated with litigation matters   0 0 0
Integration and transaction-related costs   0 0 0
Debt extinguishment costs       0
Pre-tax adjusted income (loss) from operations   96 509 903
Corporate and Eliminations        
Segment Reporting Information [Line Items]        
Net investment income (loss)   23 7 (1)
TOTAL REVENUES   (9,978) (6,991) (6,475)
Net realized investment results from certain equity method investments   0 0 0
Adjusted revenues   (9,978) (6,991) (6,475)
Depreciation and amortization   25 10 4
Income before income taxes   (1,995) (1,595) (1,790)
Special items        
Pre-tax adjusted income (loss) from operations   (1,698) (1,466) (1,339)
Corporate        
Segment Reporting Information [Line Items]        
Revenues from customers   1 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        
(Gain) loss on sale of business   0 0  
Charge for organizational efficiency plan   252 22 168
(Benefits) charges associated with litigation matters   0 (28) (27)
Integration and transaction-related costs   45 135 169
Debt extinguishment costs       141
Intersegment Eliminations        
Segment Reporting Information [Line Items]        
Revenues from customers   (10,002) (6,998) (6,474)
Intersegment Eliminations | Evernorth Health Services        
Segment Reporting Information [Line Items]        
Revenues from customers   (5,670) (4,463) (4,203)
Intersegment Eliminations | Cigna Healthcare        
Segment Reporting Information [Line Items]        
Revenues from customers   (4,332) (2,535) (2,271)
Intersegment Eliminations | Other Operations        
Segment Reporting Information [Line Items]        
Revenues from customers   $ 0 $ 0 $ 0
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Segment Information - Revenue from External Customers (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Revenue from External Customer [Line Items]      
Premiums $ 44,237 $ 39,916 [1] $ 41,154 [1]
Total revenues from external customers 194,099 179,363 172,520
Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Premiums 74 1 (9)
Total revenues from external customers (10,002) (6,998) (6,474)
Operating Segments | Divested International businesses      
Revenue from External Customer [Line Items]      
Premiums 0 1,596 3,205
Operating Segments | Other      
Revenue from External Customer [Line Items]      
Premiums 281 225 221
Evernorth Health Services      
Revenue from External Customer [Line Items]      
Total revenues from external customers 147,588 135,786 127,692
Evernorth Health Services | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Total revenues from external customers (5,670) (4,463) (4,203)
Cigna Healthcare      
Revenue from External Customer [Line Items]      
Total revenues from external customers 46,219 41,738 41,369
Cigna Healthcare | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Total revenues from external customers (4,332) (2,535) (2,271)
Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Premiums 43,882 38,094 37,737
Cigna Healthcare | Operating Segments | U.S. Healthcare      
Revenue from External Customer [Line Items]      
Premiums 40,587 35,188 35,149
Cigna Healthcare | Operating Segments | International Health      
Revenue from External Customer [Line Items]      
Premiums 3,295 2,906 2,588
Other Operations      
Revenue from External Customer [Line Items]      
Total revenues from external customers 291 1,839 3,459
Other Operations | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Total revenues from external customers 0 0 0
Pharmacy revenues      
Revenue from External Customer [Line Items]      
Revenues 137,243 128,566 [1] 121,413 [1]
Pharmacy revenues | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Revenues (5,050) (4,416) (4,398)
Network revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 67,514 64,946 64,992
Home delivery and specialty revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 65,732 61,283 54,391
Other revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 9,047 6,753 6,428
Employer insured | Cigna Healthcare | Operating Segments | U.S. Healthcare      
Revenue from External Customer [Line Items]      
Premiums 16,490 15,199 14,315
Medicare Advantage | Cigna Healthcare | Operating Segments | U.S. Healthcare      
Revenue from External Customer [Line Items]      
Premiums 8,771 7,896 8,362
Stop loss | Cigna Healthcare | Operating Segments | U.S. Healthcare      
Revenue from External Customer [Line Items]      
Premiums 6,143 5,461 4,868
Individual and Family Plans | Cigna Healthcare | Operating Segments | U.S. Healthcare      
Revenue from External Customer [Line Items]      
Premiums 5,088 2,636 2,528
Other | Cigna Healthcare | Operating Segments | U.S. Healthcare      
Revenue from External Customer [Line Items]      
Premiums 4,095 3,996 5,076
Service      
Revenue from External Customer [Line Items]      
Revenues 12,619 10,881 [1] 9,953 [1]
Service | Intersegment Eliminations      
Revenue from External Customer [Line Items]      
Revenues (5,026) (2,583) (2,067)
Fees | Evernorth Health Services | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 10,866 7,234 6,070
Fees | Cigna Healthcare | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 6,566 6,053 5,743
Fees | Other Operations | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues 3 9 19
Other revenues | Operating Segments      
Revenue from External Customer [Line Items]      
Revenues $ 210 $ 168 $ 188
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Segment Information - Financial and Performance Guarantees (Details) - USD ($)
$ in Billions
Dec. 31, 2023
Dec. 31, 2022
Pharmacy Benefits Management Services | Guarantees    
Loss Contingencies [Line Items]    
Guarantee liability $ 1.6 $ 1.3
v3.24.0.1
Segment Information - U.S. and Foreign Revenues from External Customers (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Loss Contingencies [Line Items]      
Revenues from external customers $ 194,099 $ 179,363 $ 172,520
United States      
Loss Contingencies [Line Items]      
Revenues from external customers 189,840 174,540 166,626
Foreign countries      
Loss Contingencies [Line Items]      
Revenues from external customers $ 4,259 4,823 5,894
Revenues, disposal group   $ 1,600 $ 3,200
Revenues | Customer Concentration Risk | U.S. Federal Government Agencies      
Loss Contingencies [Line Items]      
Concentration percentage 15.00% 15.00% 14.00%
Revenues from external customers | Geographic Concentration Risk | Single foreign country      
Loss Contingencies [Line Items]      
Concentration percentage 2.00% 2.00% 2.00%
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Statements of Income (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Revenues      
Net investment income (loss) $ 1,166 $ 1,155 [1] $ 1,549 [1]
TOTAL REVENUES 195,265 180,518 [1] 174,069 [1]
Operating expenses      
Selling, general and administrative expenses 14,822 13,174 [1] 13,012 [1]
TOTAL BENEFITS AND EXPENSES 186,729 172,068 [1] 166,128 [1]
Income from operations 8,536 8,450 [1] 7,941 [1]
Interest expense and other (1,446) (1,228) [1] (1,208) [1]
Debt extinguishment costs 0 0 [1] (141) [1]
Net realized investment (losses) gains (78) (487) [1] 198 [1]
Income before income taxes 5,513 8,397 [1] 6,790 [1]
Income tax benefits 141 1,615 [1] 1,370 [1]
SHAREHOLDERS' NET INCOME 5,164 6,704 [1] 5,370 [1]
Other comprehensive income (loss), net of tax      
Net long-duration insurance and contractholder liabilities measurement adjustments (715) 509 [1] 67 [1]
SHAREHOLDERS' COMPREHENSIVE INCOME 4,958 6,114 [1] 5,327 [1]
The Cigna Group      
Revenues      
Net investment income (loss) 22 5 0
Intercompany interest income 516 478 471
TOTAL REVENUES 538 483 471
Operating expenses      
Selling, general and administrative expenses 2 2 8
TOTAL BENEFITS AND EXPENSES 2 2 8
Income from operations 536 481 463
Interest expense and other (1,332) (1,215) (1,197)
Intercompany interest expense (118) (147) (13)
Debt extinguishment costs 0 0 (131)
Income before income taxes (914) (881) (878)
Income tax benefits (192) (183) (180)
Loss of Parent Company (722) (698) (698)
Equity in income of subsidiaries 5,886 7,402 6,068
SHAREHOLDERS' NET INCOME 5,164 6,704 5,370
Other comprehensive income (loss), net of tax      
Net unrealized appreciation (depreciation) on securities and derivatives 503 (1,598) (302)
Net long-duration insurance and contractholder liabilities measurement adjustments (715) 509 67
Net translation gains (losses) of foreign currencies 5 79 (218)
Postretirement benefits liability adjustment 1 420 410
Shareholders' other comprehensive loss, net of tax (206) (590) (43)
SHAREHOLDERS' COMPREHENSIVE INCOME $ 4,958 $ 6,114 $ 5,327
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Balance Sheets (Details) - USD ($)
$ in Millions
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Assets      
Cash and cash equivalents $ 7,822 $ 5,924 [1]  
Short-term investments 925 905 [1]  
Other current assets 2,169 1,298 [1]  
Total current assets 37,351 30,122 [1]  
Other non-current assets 3,421 2,704 [1]  
TOTAL ASSETS 152,761 143,885 [1]  
Liabilities      
Short-term debt 2,775 2,993 [1]  
Total current liabilities 48,716 41,225 [1]  
Other non-current liabilities 3,441 2,766 [1]  
Long-term debt 28,155 28,100 [1]  
TOTAL LIABILITIES 106,410 99,131 [1]  
Shareholders' Equity      
Common stock [2] 4 4 [1]  
Additional paid-in capital 30,669 30,233 [1]  
Accumulated other comprehensive loss (1,864) (1,658) [1]  
Retained earnings 41,652 37,940 [1]  
Less: Treasury stock, at cost (24,238) (21,844) [1]  
TOTAL SHAREHOLDERS' EQUITY 46,223 44,675 [1]  
Total liabilities and equity $ 152,761 $ 143,885 [1]  
Common stock, shares issued (in shares) 399,894,000 397,819,000 394,194,000
Common stock, shares authorized (in shares) 600,000,000 600,000,000 600,000,000
The Cigna Group      
Assets      
Cash and cash equivalents $ 303 $ 115  
Other current assets 6 6  
Total current assets 309 121  
TOTAL ASSETS 81,564 81,265  
Liabilities      
Short-term debt 2,448 2,749  
Other current liabilities 1,854 1,295  
Total current liabilities 4,302 4,044  
Long-term debt 27,151 26,815  
TOTAL LIABILITIES 35,341 36,590  
Shareholders' Equity      
Common stock 4 4  
Additional paid-in capital 30,669 30,233  
Accumulated other comprehensive loss (1,864) (1,658)  
Retained earnings 41,652 37,940  
Less: Treasury stock, at cost (24,238) (21,844)  
TOTAL SHAREHOLDERS' EQUITY 46,223 44,675  
Total liabilities and equity $ 81,564 $ 81,265  
Common stock, shares issued (in shares) 400,000,000 398,000,000  
Common stock, shares authorized (in shares) 600,000,000 600,000,000  
The Cigna Group | Nonrelated Party      
Assets      
Other non-current assets $ 77 $ 99  
Liabilities      
Other non-current liabilities 14 26  
The Cigna Group | Subsidiaries      
Assets      
Investments and Other Noncurrent Assets 69,703 70,679  
Other non-current assets 11,475 10,366  
Liabilities      
Other non-current liabilities $ 3,874 $ 5,705  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
[2] Par value per share, $0.01; shares issued, 400 million as of December 31, 2023 and 398 million as of December 31, 2022; authorized shares, 600 million.
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Statements of Cash Flows (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 21, 2023
Sep. 21, 2023
Jun. 22, 2023
Mar. 23, 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
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash Flows from Operating Activities                              
Shareholders' net income                         $ 5,164 $ 6,704 [1] $ 5,370 [1]
Adjustments to reconcile shareholders' net income to net cash provided by (used in) operating activities:                              
Debt extinguishment costs                         0 0 [1] 141 [1]
Other liabilities                         3,481 1,734 [1] 77 [1]
Other, net                         463 325 [1] 333 [1]
NET CASH PROVIDED BY OPERATING ACTIVITIES                         11,813 8,656 [1] 7,191 [1]
Cash Flows from Investing Activities                              
Net proceeds from short-term investments sold (purchased)                         (1,205) (1,563) [1] (2,554) [1]
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES                         (5,174) 3,098 [1] (3,611) [1]
Cash Flows from Financing Activities                              
Payments for debt extinguishment                         0 0 (136) [1]
Repayment of long-term debt                         (2,967) (500) [1] (4,578) [1]
Net proceeds on issuance of long-term debt                         1,491 0 [1] 4,260 [1]
Issuance of common stock                         187 389 [1] 326 [1]
Common dividends paid $ (358) $ (362) $ (362) $ (368) $ (334) $ (341) $ (352) $ (357) $ (324) $ (330) $ (342) $ (345) (1,450) (1,384) [1] (1,341) [1]
Repurchase of common stock                         (2,284) (7,607) [1] (7,742) [1]
Other, net                         (413) (23) [1] 39 [1]
NET CASH USED IN FINANCING ACTIVITIES                         (4,294) (11,240) [1] (8,212) [1]
Net increase (decrease) in cash, cash equivalents and restricted cash                         2,361 428 [1] (4,697) [1]
Cash, cash equivalents and restricted cash and cash equivalents January 1, [1],[2]                         5,976 5,123  
Cash, cash equivalents and restricted cash, end of year (2) [2]                         7,870 5,976 [1] 5,123 [1]
The Cigna Group                              
Cash Flows from Operating Activities                              
Shareholders' net income                         5,164 6,704 5,370
Adjustments to reconcile shareholders' net income to net cash provided by (used in) operating activities:                              
Equity in income of subsidiaries                         (5,886) (7,402) (6,068)
Debt extinguishment costs                         0 0 131
Dividends received from subsidiaries                         1,381 2,056 2,726
Other liabilities                         540 5 184
Other, net                         640 298 439
NET CASH PROVIDED BY OPERATING ACTIVITIES                         1,839 1,661 2,782
Cash Flows from Investing Activities                              
Net proceeds from short-term investments sold (purchased)                         0 99 (50)
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES                         622 (802) (1,057)
Cash Flows from Financing Activities                              
Net change in short-term debt                         1,237 (2,027) 997
Payments for debt extinguishment                         0 0 (126)
Repayment of long-term debt                         (2,822) (430) (4,199)
Net proceeds on issuance of long-term debt                         1,491 0 4,260
Issuance of common stock                         187 389 326
Common dividends paid                         (1,450) (1,384) (1,341)
Repurchase of common stock                         (2,284) (7,607) (7,742)
Tax withholding on stock compensation and other                         (110) (73) (86)
NET CASH USED IN FINANCING ACTIVITIES                         (2,278) (740) (5,849)
Net increase (decrease) in cash, cash equivalents and restricted cash                         183 119 (4,124)
Cash, cash equivalents and restricted cash and cash equivalents January 1,                         152 33 4,157
Cash, cash equivalents and restricted cash, end of year (2)                         335 152 33
The Cigna Group | Subsidiaries                              
Cash Flows from Investing Activities                              
Net change in amounts due from affiliates                         622 (901) (1,007)
Cash Flows from Financing Activities                              
Net change in amounts due to affiliates                         1,473 10,392 2,062
Net amounts due to/(from) affiliates settled through capital transactions                         $ (5,221) $ (5,037) $ (8,429)
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
[2] Restricted cash and cash equivalents were reported in other long-term investments.
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Short-term and Credit Facilities Debt (Details)
 1 Months Ended 12 Months Ended
Apr. 30, 2023
USD ($)
bank
position
Apr. 30, 2022
USD ($)
Dec. 31, 2023
USD ($)
Line of Credit Facility [Line Items]      
Commercial paper average interest rate     5.63%
Commercial Paper      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity     $ 5,000,000,000
Revolving credit agreements, 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 | position 21    
Leverage ratio covenant 60.00%    
Five-year Revolving Credit Agreement, Maturing April 2028      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 4,000,000,000    
Credit agreement term 5 years    
Credit agreement extension term 1 year    
Five-year Revolving Credit Agreement, Maturing April 2028 | Letter of Credit      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 500,000,000    
364-day Revolving Credit Agreement, Maturing April 2024      
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    
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  
Revolving Credit Facility Maturing April 2025      
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 2023      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   364 days  
The Cigna Group      
Line of Credit Facility [Line Items]      
Commercial paper average interest rate     5.63%
The Cigna Group | Commercial Paper      
Line of Credit Facility [Line Items]      
Outstanding balances     $ 1,200,000,000
Maximum borrowing capacity     5,000,000,000
The Cigna Group | Revolving credit agreements, 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 21    
Leverage ratio covenant 60.00%    
The Cigna Group | Five-year Revolving Credit Agreement, Maturing April 2028      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 4,000,000,000    
Credit agreement term 5 years    
Credit agreement extension term 1 year    
The Cigna Group | Five-year Revolving Credit Agreement, Maturing April 2028 | Letter of Credit      
Line of Credit Facility [Line Items]      
Maximum borrowing capacity $ 500,000,000    
The Cigna Group | 364-day Revolving Credit Agreement, Maturing April 2024      
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 | 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    
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    
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    
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Long-term Debt (Details)
 12 Months Ended
Mar. 07, 2023
USD ($)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Feb. 22, 2024
USD ($)
Feb. 05, 2024
USD ($)
Debt Instrument [Line Items]            
Debt extinguishment costs   $ 0 $ 0 [1] $ 141,000,000 [1]    
Repayment of long-term debt   $ 2,967,000,000 500,000,000 [1] 4,578,000,000 [1]    
Forecast            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed         $ 2,550,000,000 $ 2,250,000,000
Subsequent Event            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed         1,800,000,000  
$700 million, 5.685% Notes due March 2026            
Debt Instrument [Line Items]            
Interest Rate   5.685%        
Gross value   $ 700,000,000        
$800 million, 5.400% Notes due March 2033            
Debt Instrument [Line Items]            
Interest Rate   5.40%        
Gross value   $ 800,000,000        
$1,000 million, 3.500% Notes due June 2024            
Debt Instrument [Line Items]            
Interest Rate   3.50%        
Gross value   $ 1,000,000,000        
$1,000 million, 3.500% Notes due June 2024 | Forecast            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed           1,000,000,000
Senior Notes            
Debt Instrument [Line Items]            
Principal $ 1,500,000,000          
Senior Notes | $700 million, 5.685% Notes due March 2026            
Debt Instrument [Line Items]            
Principal 700,000,000          
Net proceeds $ 698,000,000          
Interest Rate 5.685%          
Senior Notes | $700 million, 5.685% Notes due March 2026 | Treasury rate            
Debt Instrument [Line Items]            
Redemption price discount, spread on variable rate 0.0020          
Senior Notes | $800 million, 5.400% Notes due March 2033            
Debt Instrument [Line Items]            
Principal $ 800,000,000          
Net proceeds $ 796,000,000          
Interest Rate 5.40%          
Senior Notes | $800 million, 5.400% Notes due March 2033 | Treasury rate            
Debt Instrument [Line Items]            
Redemption price discount, spread on variable rate 0.0025          
The Cigna Group            
Debt Instrument [Line Items]            
Debt extinguishment costs   0 0 131,000,000    
Repayment of long-term debt   $ 2,822,000,000 $ 430,000,000 $ 4,199,000,000    
The Cigna Group | Forecast            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed         2,550,000,000 2,250,000,000
The Cigna Group | Subsequent Event            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed         $ 1,800,000,000  
The Cigna Group | $1,000 million, 3.500% Notes due June 2024 | Forecast            
Debt Instrument [Line Items]            
Aggregate principal amount of outstanding debt securities redeemed           1,000,000,000
The Cigna Group | Senior Notes            
Debt Instrument [Line Items]            
Principal $ 1,500,000,000          
The Cigna Group | Senior Notes | Subsequent Event            
Debt Instrument [Line Items]            
Principal           $ 4,500,000,000
The Cigna Group | Senior Notes | $700 million, 5.685% Notes due March 2026            
Debt Instrument [Line Items]            
Principal 700,000,000          
Net proceeds $ 698,000,000          
Interest Rate 5.685%          
The Cigna Group | Senior Notes | $700 million, 5.685% Notes due March 2026 | Treasury rate            
Debt Instrument [Line Items]            
Redemption price discount, spread on variable rate 0.0020          
The Cigna Group | Senior Notes | $800 million, 5.400% Notes due March 2033            
Debt Instrument [Line Items]            
Principal $ 800,000,000          
Net proceeds $ 796,000,000          
Interest Rate 5.40%          
The Cigna Group | Senior Notes | $800 million, 5.400% Notes due March 2033 | Treasury rate            
Debt Instrument [Line Items]            
Redemption price discount, spread on variable rate 0.0025          
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Debt Maturities (Details)
$ in Millions
Dec. 31, 2023
USD ($)
Debt Instrument [Line Items]  
2024 $ 1,500
2025 3,100
2026 3,000
2027 2,359
2028 3,800
Maturities after 2028 16,122
The Cigna Group  
Debt Instrument [Line Items]  
2024 1,214
2025 2,957
2026 2,734
2027 2,056
2028 3,800
Maturities after 2028 $ 15,091
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Intercompany Balances (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Condensed Financial Statements, Captions [Line Items]    
Other current assets $ 2,169 $ 1,298 [1]
The Cigna Group    
Condensed Financial Statements, Captions [Line Items]    
Other current assets 6 6
The Cigna Group | Evernorth Health, Inc.    
Condensed Financial Statements, Captions [Line Items]    
Other current assets $ 8,500 $ 8,300
Interest rate, intercompany receivables 5.21%  
The Cigna Group | Three wholly-owned subsidiaries    
Condensed Financial Statements, Captions [Line Items]    
Average interest rate on intercompany loan 3.65%  
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Guarantees (Details) - The Cigna Group - USD ($)
$ in Billions
Jan. 31, 2024
Dec. 31, 2023
Guarantor Obligations [Line Items]    
Maximum guarantee exposure   $ 2.9
Subsequent Event    
Guarantor Obligations [Line Items]    
Maximum guarantee exposure $ 6.4  
v3.24.0.1
Schedule I - Condensed Financial Information of The Cigna Group - Share Repurchase (Details) - USD ($)
shares in Millions
 1 Months Ended 6 Months Ended 12 Months Ended
Feb. 15, 2024
Nov. 30, 2022
Jul. 31, 2022
Dec. 31, 2022
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Jun. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Accelerated stock repurchase, amount authorized               $ 3,500,000,000
Accelerated stock repurchase, amount remitted     $ 3,500,000,000          
Stock repurchased (in shares)   1.9 10.4 12.3        
Stock repurchased         $ 2,282,000,000 $ 7,593,000,000 $ 7,710,000,000  
Subsequent Event                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Accelerated stock repurchase, amount authorized $ 3,200,000,000              
Accelerated stock repurchase, amount remitted $ 3,200,000,000              
Stock repurchased (in shares) 7.6              
The Cigna Group | Subsequent Event                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Accelerated stock repurchase, amount authorized $ 3,200,000,000              
Accelerated stock repurchase, amount remitted $ 3,200,000,000              
Stock repurchased (in shares) 7.6              
Stock repurchased $ 2,600,000,000              
v3.24.0.1
Schedule II - Valuation and Qualifying Accounts and Reserves (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Available-for-sale debt securities      
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]      
Balance at beginning of year $ 44 $ 23 $ 26
Charged (Credited) to costs and expenses 11 43 29
Charged (Credited) to other accounts 0 0 0
Other deductions (22) (22) (32)
Balance at end of year 33 44 23
Valuation allowance 33 44 23
Commercial mortgage loans      
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]      
Balance at beginning of year 21 6 6
Charged (Credited) to costs and expenses 10 15 0
Charged (Credited) to other accounts 0 0 0
Other deductions 0 0 0
Balance at end of year 31 21 6
Valuation allowance 31 21 6
Accounts receivable, net      
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]      
Balance at beginning of year 160 126 156
Charged (Credited) to costs and expenses 90 99 54
Charged (Credited) to other accounts 1 0 0
Other deductions (88) (65) (84)
Balance at end of year 163 160 126
Valuation allowance 163 160 126
Deferred tax asset valuation allowance      
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]      
Balance at beginning of year 208 246 207
Charged (Credited) to costs and expenses 1,286 (13) 23
Charged (Credited) to other accounts 4 (25) 16
Other deductions 0 0 0
Balance at end of year 1,498 208 246
Valuation allowance 1,498 208 246
Reinsurance recoverables      
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]      
Balance at beginning of year 35 28 30
Charged (Credited) to costs and expenses 0 7 (2)
Charged (Credited) to other accounts 0 0 0
Other deductions 0 0 0
Balance at end of year 35 35 28
Valuation allowance $ 35 $ 35 $ 28