CIGNA GROUP, 10-Q filed on 5/2/2024
Quarterly Report
v3.24.1.u1
Cover Page - shares
 3 Months Ended
Mar. 31, 2024
Apr. 30, 2024
Cover [Abstract]    
Document Type 10-Q  
Document Quarterly Report true  
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 $0.01  
Trading Symbol CI  
Security Exchange Name NYSE  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Filer Category Large Accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Shell Company false  
Entity Common Stock, Shares Outstanding   284,074,001
Document Fiscal Period Focus Q1  
Document Fiscal Year Focus 2024  
Current Fiscal Year End Date --12-31  
Amendment Flag false  
Entity Central Index Key 0001739940  
Document Period End Date Mar. 31, 2024  
v3.24.1.u1
Consolidated Statements of Income - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Revenues    
Premiums $ 11,603 $ 11,025
Net investment income 290 277
TOTAL REVENUES 57,255 46,517
Benefits and expenses    
Pharmacy and other service costs 41,431 31,459
Medical costs and other benefit expenses 9,440 9,046
Selling, general and administrative expenses 3,705 3,538
Amortization of acquired intangible assets 423 459
TOTAL BENEFITS AND EXPENSES 54,999 44,502
Income from operations 2,256 2,015
Interest expense and other (322) (358)
Loss on sale of businesses (19) 0
Net realized investment losses (1,836) (56)
Income before income taxes 79 1,601
TOTAL INCOME TAXES 291 295
Net (loss) income (212) 1,306
Less: Net income attributable to noncontrolling interests 65 39
SHAREHOLDERS' NET (LOSS) INCOME $ (277) $ 1,267
Shareholders' net (loss) income per share    
Basic (in dollars per share) $ (0.97) $ 4.28
Diluted (in dollars per share) $ (0.97) $ 4.24
Pharmacy revenues    
Revenues    
Revenues $ 42,036 $ 32,144
Fees and other revenues    
Revenues    
Revenues $ 3,326 $ 3,071
v3.24.1.u1
Consolidated Statements of Comprehensive Income - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Statement of Comprehensive Income [Abstract]    
Net income $ (212) $ 1,306
Other comprehensive income (loss), net of tax    
Net unrealized appreciation on securities and derivatives 121 194
Net long-duration insurance and contractholder liabilities measurement adjustments (560) (331)
Net translation (losses) gains on foreign currencies (26) 16
Postretirement benefits liability adjustment 5 10
Other comprehensive loss, net of tax (460) (111)
Total comprehensive (loss) income (672) 1,195
Comprehensive income (loss) attributable to noncontrolling interests    
Net income attributable to redeemable noncontrolling interests 0 34
Net income attributable to other noncontrolling interests 65 5
Other comprehensive loss attributable to redeemable noncontrolling interests 0 0
Total comprehensive income attributable to noncontrolling interests 65 39
SHAREHOLDERS' COMPREHENSIVE (LOSS) INCOME $ (737) $ 1,156
v3.24.1.u1
Consolidated Balance Sheets - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Assets    
Cash and cash equivalents $ 8,439 $ 7,822
Investments 1,108 925
Accounts receivable, net 20,563 17,722
Inventories 4,630 5,645
Other current assets 2,263 2,169
Assets of businesses held for sale 6,354 3,068
Total current assets 43,357 37,351
Long-term investments 16,025 17,985
Reinsurance recoverables 4,672 4,835
Property and equipment 3,607 3,695
Goodwill 44,258 44,259
Other intangible assets 30,491 30,863
Other assets 3,293 3,421
Separate account assets 7,416 7,430
Assets of businesses held for sale, non-current 0 2,922
TOTAL ASSETS 153,119 152,761
Liabilities    
Current insurance and contractholder liabilities 5,788 5,514
Pharmacy and other service costs payable 24,284 19,815
Accounts payable 8,118 8,553
Accrued expenses and other liabilities 8,857 9,955
Short-term debt 1,715 2,775
Liabilities of businesses held for sale 3,215 2,104
Total current liabilities 51,977 48,716
Non-current insurance and contractholder liabilities 10,641 10,904
Deferred tax liabilities, net 7,029 7,173
Other non-current liabilities 3,653 3,441
Long-term debt 31,053 28,155
Separate account liabilities 7,416 7,430
Liabilities of businesses held for sale, non-current 0 591
TOTAL LIABILITIES 111,769 106,410
Contingencies — Note 16
Redeemable noncontrolling interests 0 107
Shareholders' equity    
Common stock [1] 4 4
Additional paid-in capital 30,292 30,669
Accumulated other comprehensive loss (2,324) (1,864)
Retained earnings 40,978 41,652
Less: Treasury stock, at cost (27,769) (24,238)
TOTAL SHAREHOLDERS' EQUITY 41,181 46,223
Other noncontrolling interests 169 21
Total equity 41,350 46,244
Total liabilities and equity $ 153,119 $ 152,761
[1] Par value per share, $0.01; shares issued, 402 million as of March 31, 2024 and 400 million as of December 31, 2023; authorized shares, 600 million.
v3.24.1.u1
Consolidated Balance Sheets (Parenthetical) - $ / shares
Mar. 31, 2024
Dec. 31, 2023
Statement of Financial Position [Abstract]    
Common stock, par value (in dollars per share) $ 0.01 $ 0.01
Common stock, shares issued (in shares) 402,000,000 400,000,000
Common stock, shares authorized (in shares) 600,000,000 600,000,000
v3.24.1.u1
Consolidated Statements of Changes in Total Equity - USD ($)
$ in Millions
Total
Shareholders' Equity
Common Stock
Additional Paid-in Capital
Accumulated Other Comprehensive (Loss)
Retained Earnings
Treasury Stock
Other Non- controlling Interests
Balance at Dec. 31, 2022 $ 44,688 $ 44,675 $ 4 $ 30,233 $ (1,658) $ 37,940 $ (21,844) $ 13
Changes in Total Equity                
Effect of issuing stock for employee benefit plans (5) (5)   99     (104)  
Other comprehensive income (loss) (111) (111)     (111)      
Net (loss) income 1,272 1,267       1,267   5
Common dividends declared (366) (366)       (366)    
Stock repurchased 958 958   0     958  
Other transactions impacting noncontrolling interests (2) 0   0       (2)
Balance at Mar. 31, 2023 44,518 44,502 4 30,332 (1,769) 38,841 (22,906) 16
Balance at Dec. 31, 2022 66              
Change in Redeemable Noncontrolling Interests                
Other comprehensive loss 0              
Net income 34              
Other transactions impacting noncontrolling interests (22)              
Balance at Mar. 31, 2023 78              
Balance at Dec. 31, 2023 46,244 46,223 4 30,669 (1,864) 41,652 (24,238) 21
Changes in Total Equity                
Effect of issuing stock for employee benefit plans 149 149   263     (114)  
Other comprehensive income (loss) (460) (460)     (460)      
Net (loss) income (212) (277)       (277)   65
Common dividends declared (397) (397)       (397)    
Stock repurchased 4,057 4,057   640     3,417  
Other transactions impacting noncontrolling interests 83 0   0       83
Balance at Mar. 31, 2024 41,350 $ 41,181 $ 4 $ 30,292 $ (2,324) $ 40,978 $ (27,769) $ 169
Balance at Dec. 31, 2023 107              
Change in Redeemable Noncontrolling Interests                
Other comprehensive loss 0              
Net income 0              
Other transactions impacting noncontrolling interests (107)              
Balance at Mar. 31, 2024 $ 0              
v3.24.1.u1
Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Statement of Stockholders' Equity [Abstract]    
Common dividends declared (in dollars per share) $ 1.40 $ 1.23
v3.24.1.u1
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Cash Flows from Operating Activities    
Net income $ (212) $ 1,306
Adjustments to reconcile net (loss) income to net cash provided by operating activities:    
Depreciation and amortization 741 749
Realized investment losses, net 1,836 56
Deferred income tax benefit (102) (108)
Loss on sale of businesses 19 0
Net changes in assets and liabilities, net of non-operating effects:    
Accounts receivable, net (2,687) (479)
Inventories 1,015 566
Reinsurance recoverable and Other assets 68 72
Insurance liabilities 532 1,533
Pharmacy and other service costs payable 4,637 539
Accounts payable and Accrued expenses and other liabilities (1,068) 690
Other, net 61 104
NET CASH PROVIDED BY OPERATING ACTIVITIES 4,840 5,028
Proceeds from investments sold:    
Debt securities and equity securities 268 196
Investment maturities and repayments:    
Debt securities and equity securities 179 257
Commercial mortgage loans 4 4
Other sales, maturities and repayments (primarily short-term and other long-term investments) 272 160
Investments purchased or originated:    
Debt securities and equity securities (180) (2,794)
Commercial mortgage loans (32) 0
Other (primarily short-term and other long-term investments) (594) (377)
Property and equipment purchases, net (300) (408)
Divestitures, net of cash sold 0 22
Other, net (112) (43)
NET CASH USED IN INVESTING ACTIVITIES (495) (2,983)
Cash Flows from Financing Activities    
Deposits and interest credited to contractholder deposit funds 43 45
Withdrawals and benefit payments from contractholder deposit funds (65) (48)
Net change in short-term debt (364) (9)
Repayment of long-term debt (2,210) (80)
Net proceeds on issuance of long-term debt 4,462 1,491
Repurchase of common stock (4,022) (962)
Issuance of common stock 181 30
Common stock dividend paid (401) (368)
Other, net (153) (136)
NET CASH USED IN FINANCING ACTIVITIES (2,529) (37)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash (9) 5
Net increase in cash, cash equivalents and restricted cash 1,807 2,013
Cash, cash equivalents and restricted cash January 1, including held for sale assets 8,337 5,976
Cash, cash equivalents and restricted cash December 31, including held for sale assets [1] 10,144 7,989
Cash and cash equivalents reclassified to assets of businesses held for sale (1,660) 0
Cash, cash equivalents and restricted cash and cash equivalents December 31, [1] 8,484 7,989
Supplemental Disclosure of Cash Information:    
Income taxes paid, net of refunds 110 77
Interest paid $ 336 $ 322
[1] Restricted cash and cash equivalents were reported in other long-term investments.
v3.24.1.u1
Description of Business
 3 Months Ended
Mar. 31, 2024
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 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:
The Evernorth Health Services reportable segment now presents the Pharmacy Benefit Services and the Specialty and Care Services operating segments, which partner 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.

Pharmacy Benefit Services drives high-quality, cost-effective pharmacy care through various services such as drug claim adjudication, retail pharmacy network administration, benefit design consultation, drug utilization review, drug formulary management and access to our home delivery pharmacy. Specialty and Care Services provides specialty drugs for the treatment of complex and rare diseases, specialty distribution of pharmaceuticals and medical supplies, as well as clinical programs to help our clients drive better whole-person health outcomes through Care Delivery and Management Solutions. The Company's reporting units remain aligned with its operating segments and goodwill was allocated on a relative fair value basis.

The Cigna Healthcare reportable segment includes the U.S. Healthcare and International Health operating segments, which provide comprehensive medical and coordinated solutions to clients and customers. U.S. Healthcare provides medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Stand-Alone Prescription Drug 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 approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions (the "HCSC transaction"). See Note 5 to the Consolidated Financial Statements for further information.
Other Operations comprises the remainder of our business operations, which includes our continuing business (corporate-owned life insurance ("COLI")) and our run-off and other non-strategic businesses. Our run-off businesses include (i) variable annuity reinsurance 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.
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.
v3.24.1.u1
Summary of Significant Accounting Policies
 3 Months Ended
Mar. 31, 2024
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").
Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax 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.
These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2023 Annual Report on Form 10-K ("2023 Form 10-K"). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations.
Recent Accounting Pronouncements
The Company's 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.
v3.24.1.u1
Accounts Receivable, Net
 3 Months Ended
Mar. 31, 2024
Receivables [Abstract]  
Accounts Receivable, Net
Note 3 – Accounts Receivable, Net
The following amounts were included within Accounts receivable, net:
(In millions)March 31, 2024December 31, 2023
Noninsurance customer receivables$9,735 $8,044 
Pharmaceutical manufacturers receivables9,512 8,169 
Insurance customer receivables2,045 2,359 
Other receivables230 272 
Total$21,522 $18,844 
Accounts receivable, net classified as assets of businesses held for sale
(959)(1,122)
Total$20,563 $17,722 
These accounts receivable are reported net of our allowances of $4.5 billion as of March 31, 2024 and $3.7 billion as of December 31, 2023. These allowances include contractual allowances for certain rebates receivable with pharmaceutical manufacturers and certain accounts receivable from third-party payors, 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 $91 million as of March 31, 2024 and $90 million as of December 31, 2023.
Accounts Receivable Factoring Facility
The Company maintains 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 and began in July 2023 with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.
For the three months ended March 31, 2024, we sold $1.9 billion of accounts receivable under the Facility and factoring fees paid were not material. As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.
v3.24.1.u1
Supplier Finance Program
 3 Months Ended
Mar. 31, 2024
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. Further information regarding the Program's terms can be found in Note 4 in the Company's 2023 Form 10-K.
As of March 31, 2024 and December 31, 2023, $1.6 billion and $1.5 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 March 31, 2024, we have been informed by the financial institution that $327 million of the Company's outstanding payment obligations were voluntarily elected by suppliers to be sold to the financial institution under the Program.
v3.24.1.u1
Assets and Liabilities of Businesses Held for Sale
 3 Months Ended
Mar. 31, 2024
Discontinued Operations and Disposal Groups [Abstract]  
Assets and Liabilities of Business Held for Sale
Note 5 – Assets and Liabilities of Businesses Held for Sale
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.
The assets and liabilities of businesses held for sale were as follows:
(In millions)March 31, 2024December 31, 2023
Cash and cash equivalents$1,660 $467 
Investments1,341 1,438 
Accounts receivable, net959 1,122 
Other assets, including Goodwill (1)
2,394 2,963 
Total assets of businesses held for sale6,354 5,990 
Insurance and contractholder liabilities2,081 1,636 
All other liabilities1,134 1,059 
Total liabilities of businesses held for sale$3,215 $2,695 
(1) Includes Goodwill of $396 million as of March 31, 2024 and December 31, 2023.
Integration and Transaction-related Costs
In 2024, the Company incurred costs related to the HCSC transaction. In 2023, the Company incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction"). 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. These costs were $37 million pre-tax ($29 million after-tax) for the three months ended March 31, 2024 and $1 million pre-tax ($1 million after-tax) for the three months ended March 31, 2023.
v3.24.1.u1
Earnings Per Share
 3 Months Ended
Mar. 31, 2024
Earnings Per Share [Abstract]  
Earnings Per Share
Note 6 – Earnings Per Share
Basic and diluted earnings per share were computed as follows:
Three Months Ended
March 31, 2024March 31, 2023
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution		DilutedBasicEffect of
Dilution		Diluted
Shareholders' net (loss) income
$(277)$(277)$1,267 $1,267 
Shares:
Weighted average286,465 286,465 295,706 295,706 
Common stock equivalents— â€” 3,293 3,293 
Total shares286,465 â€” 286,465 295,706 3,293 298,999 
Earnings per share$(0.97)$— $(0.97)$4.28 $(0.04)$4.24 
Due to the Shareholders' net loss for the three months ended March 31, 2024, 8.2 million outstanding employee stock options, unvested restricted stock grants and units and strategic performance shares were excluded in the computation of diluted earnings per share because their effect was anti-dilutive. For the three months ended March 31, 2023, 0.9 million outstanding employee stock options were excluded in the computation of diluted earnings per share because their effect was anti-dilutive.
The Company held approximately 117.8 million shares of common stock in treasury at March 31, 2024, 107.4 million shares as of December 31, 2023 and 102.7 million shares as of March 31, 2023.
The increase in Treasury stock as of March 31, 2024 and the reduction in weighted average shares outstanding for the three months ended March 31, 2024 was driven in part by 7.6 million shares of our common stock repurchased in February 2024 under the accelerated share repurchase agreements (the "ASR agreements"). Additionally, we expect final settlement of the ASR agreements to occur in the second quarter of 2024. See Note 8 for additional information.
v3.24.1.u1
Debt
 3 Months Ended
Mar. 31, 2024
Debt Disclosure [Abstract]  
Debt
Note 7 – Debt
The outstanding amounts of debt (net of issuance costs, discounts or premiums) and finance leases were as follows:
(In millions)March 31, 2024December 31, 2023
Short-term debt
Commercial paper$884 $1,237 
$500 million, 0.613% Notes due March 2024
— 500 
$790 million, 3.500% Notes due June 2024 (1)
789 996 
Other, including finance leases42 42 
Total short-term debt$1,715 $2,775 
Long-term debt
$900 million, 3.250% Notes due April 2025 (2)
881 882 
$1,216 million, 4.125% Notes due November 2025 (1)
1,214 2,197 
$1,284 million, 4.500% Notes due February 2026 (1)
1,285 1,502 
$550 million, 1.250% Notes due March 2026 (1)
549 798 
$700 million, 5.685% Notes due March 2026
698 698 
$1,500 million, 3.400% Notes due March 2027
1,454 1,450 
$259 million, 7.875% Debentures due May 2027
259 259 
$600 million, 3.050% Notes due October 2027
598 597 
$3,800 million, 4.375% Notes due October 2028
3,788 3,787 
$1,000 million, 5.000% Notes due May 2029
994 â€” 
$1,400 million, 2.400% Notes due March 2030 (1)
1,394 1,493 
$1,500 million, 2.375% Notes due March 2031 (2)
1,382 1,397 
$750 million, 5.125% Notes due May 2031
745 â€” 
$45 million, 8.080% Step Down Notes due January 2033 (3)
45 45 
$800 million, 5.400% Notes due March 2033
794 794 
$1,250 million, 5.250% Notes due February 2034
1,242 â€” 
$190 million, 6.150% Notes due November 2036
190 190 
$2,200 million, 4.800% Notes due August 2038
2,193 2,193 
$750 million, 3.200% Notes due March 2040
744 744 
$121 million, 5.875% Notes due March 2041
119 119 
$448 million, 6.125% Notes due November 2041
487 487 
$317 million, 5.375% Notes due February 2042
315 315 
$1,500 million, 4.800% Notes due July 2046
1,467 1,467 
$1,000 million, 3.875% Notes due October 2047
989 989 
$3,000 million, 4.900% Notes due December 2048
2,970 2,970 
$1,250 million, 3.400% Notes due March 2050
1,237 1,237 
$1,500 million, 3.400% Notes due March 2051
1,479 1,479 
$1,500 million, 5.600% Notes due February 2054
1,482 â€” 
Other, including finance leases59 66 
Total long-term debt$31,053 $28,155 
(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 11 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 March 31, 2024, there were no outstanding balances under these revolving credit agreements.
In April 2024, The Cigna Group replaced our existing $4.0 billion five-year revolving credit and letter of credit agreement maturing in April 2028 and a $1.0 billion 364-day revolving credit agreement maturing in April 2024 by entering into the following revolving credit agreements (the "Credit Agreements"):
•a $5.0 billion five-year revolving credit and letter of credit agreement that will mature in April 2029 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 $5.0 billion under the credit agreement for general corporate purposes, with up to $500 million available for issuance of letters of credit.
•a $1.5 billion 364-day revolving credit agreement that will mature in April 2025. The Company can borrow up to $1.5 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.
The increase in the aggregate size of our revolving credit agreements from $5.0 billion to $6.5 billion will provide enhanced liquidity to support the continued growth of our business.

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 $8.0 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 22 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 March 31, 2024. 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.
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 5.54% at March 31, 2024.
Long-term debt
Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes, as detailed in the table below. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock. Interest on this debt is paid semi-annually.

PrincipalMaturity DateInterest RateNet Proceeds
$1,000 million (1)
May 15, 20295.000%$995 million
$750 million (2)
May 15, 20315.125%$746 million
$1,250 million (3)
February 15, 20345.250%$1,244 million
$1,500 million (4)
February 15, 20545.600%$1,485 million
(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after April 15, 2029.
(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after March 15, 2031.
(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after November 15, 2033.
(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after August 15, 2053.
In the first quarter of 2024, the Company completed the repurchase of a total of $1.8 billion in aggregate principal amount of existing senior notes that were tendered to the Company pursuant to cash tender offers.
Interest Expense
Interest expense on long-term and short-term debt was $369 million for the three months ended March 31, 2024 and $345 million for the three months ended March 31, 2023.
Debt Covenants

The Company was in compliance with its debt covenants as of March 31, 2024.
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Common and Preferred Stock
 3 Months Ended
Mar. 31, 2024
Equity [Abstract]  
Common and Preferred Stock
Note 8 – Common and Preferred Stock
Dividends

In the first quarter of 2024, The Cigna Group declared quarterly cash dividends of $1.40 per share of the Company's common stock. In the first quarter of 2023, The Cigna Group declared quarterly cash dividends of $1.23 per share of the Company's common stock.
The following table provides details of the Company's dividend payments:
Record DatePayment DateAmount per Share
Total Amount Paid (in millions)
2024
March 6, 2024March 21, 2024$1.40$401
2023
March 8, 2023March 23, 2023$1.23$368
On April 24, 2024, the Board of Directors declared the second quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on June 20, 2024 to shareholders of record on June 4, 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 share repurchase program, we entered into separate accelerated share repurchase agreements with Deutsche Bank AG and Bank of America, N.A. (collectively, the "Counterparties") to repurchase $3.2 billion of common stock in aggregate. We remitted $3.2 billion to the 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 ("VWAP") 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 recorded the payment to the Counterparties as a reduction to Total shareholders' equity, consisting of a $2.6 billion increase in Treasury stock, which reflects the value of the initial 7.6 million shares received, and a $640 million decrease in Additional paid-in capital, which reflects the value of the stock hold-back by the Counterparties pending final settlement of the ASR agreements. The $640 million recorded in Additional paid-in capital will be reclassified to Treasury stock upon settlement of the ASR agreements in the second quarter of 2024. The initial delivery of shares resulted in an immediate reduction of the outstanding shares used to calculate the weighted-average common shares outstanding for basic and diluted earnings per share.
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Insurance and Contractholder Liabilities
 3 Months Ended
Mar. 31, 2024
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:
March 31, 2024December 31, 2023March 31, 2023
(In millions)CurrentNon-currentTotalCurrentNon-currentTotalTotal
Unpaid claims and claim expenses
Cigna Healthcare
$5,786 $77 $5,863 $5,017 $75 $5,092 $4,959 
Other Operations99 161 260 99 154 253 272 
Future policy benefits
Cigna Healthcare
92 515 607 97 518 615 601 
Other Operations163 3,297 3,460 163 3,375 3,538 3,631 
Contractholder deposit funds
Cigna Healthcare
11 130 141 12 133 145 163 
Other Operations365 6,087 6,452 362 6,178 6,540 6,670 
Market risk benefits26 865 891 37 966 1,003 1,220 
Unearned premiums815 21 836 846 22 868 1,440 
Total7,357 11,153 18,510 6,633 11,421 18,054 
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)
(1,569)(512)(2,081)(1,119)(517)(1,636)
Total insurance and contractholder liabilities$5,788 $10,641 $16,429 $5,514 $10,904 $16,418 $18,956 
(1) Amounts classified as liabilities of businesses held for sale include $1,378 million of Unpaid claims, $427 million of Future policy benefits, $161 million of Unearned premiums and $115 million of Contractholder deposit funds as of March 31, 2024 and $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.
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.
The total of incurred but not reported liabilities plus expected development on reported claims and reported claims in process was $5.4 billion at March 31, 2024 and $4.6 billion at March 31, 2023. This increase was primarily due to claim submission and payment process disruptions related to a third-party cyber incident.
Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows:
Three Months Ended March 31,
(In millions)
2024 (1)
2023
Beginning balance$5,092 $4,176 
Less: Reinsurance and other amounts recoverable236 221 
Beginning balance, net4,856 3,955 
Incurred costs related to:
Current year9,452 9,041 
Prior years(226)(144)
Total incurred9,226 8,897 
Paid costs related to:
Current year5,072 5,316 
Prior years3,352 2,795 
Total paid8,424 8,111 
Ending balance, net5,658 4,741 
Add: Reinsurance and other amounts recoverable205 218 
Ending balance$5,863 $4,959 
(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of March 31, 2024 and December 31, 2023, $1,378 million and $823 million classified as liabilities of businesses held for sale, respectively.
Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 to the Consolidated Financial Statements for additional information on reinsurance.
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
Three Months Ended March 31,
20242023
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors$76 0.2 %$1 â€” %
Medical cost trend150 0.4 143 0.5 
Total favorable variance$226 0.6 %$144 0.5 %
(1)Percentage of current year incurred costs as reported for the year ended December 31, 2023.
(2)Percentage of current year incurred costs as reported for the year ended December 31, 2022.

Favorable prior year development in both years reflects lower than expected utilization of medical services as compared to our assumptions.
Future Policy Benefits
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
March 31, 2024March 31, 2023
Interest accretion rate 2.56 %2.59 %
Current discount rate 5.11 %5.29 %
Weighted average duration 7.8 years8.1 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 were as follows:
Three Months Ended March 31,
(In millions)
2024 (1)
2023
Present value of expected net premiums
Beginning balance$9,233 $8,557 
Reversal of effect of beginning of period discount rate assumptions1,154 1,537 
Issuances and lapses 446 306 
Net premiums collected(350)(326)
Interest and other (2)
73 56 
Ending balance at original discount rate10,556 10,130 
Effect of end of period discount rate assumptions(1,309)(1,312)
Ending balance (3)
$9,247 $8,818 
Present value of expected policy benefits
Beginning balance$9,633 $8,945 
Reversal of effect of discount rate assumptions1,220 1,611 
Issuances and lapses 457 307 
Benefit payments(362)(326)
Interest and other (2)
71 58 
Ending balance at original discount rate11,019 10,595 
Effect of discount rate assumptions(1,381)(1,378)
Ending balance (4)
$9,638 $9,217 
Liability for future policy benefits $391 $399 
Other (5)
216 202 
Total liability for future policy benefits (6)(7)
$607 $601 
(1)Includes future policy benefits amounts classified as liabilities of businesses held for sale.
(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 March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $19.0 billion and $17.6 billion, respectively. As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $13.3 billion and $12.5 billion, respectively.
(4)As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $13.6 billion and $12.8 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 $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits. Additionally, $81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.
(7)Includes $427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.
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
March 31, 2024March 31, 2023
Interest accretion rate 5.64 %5.64 %
Current discount rate 5.16 %4.95 %
Weighted average duration 11.3 years11.7 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 $379 million as of March 31, 2024 and $392 million as of March 31, 2023. Future policy benefits excluding deferred profit liability were $3.1 billion as of March 31, 2024 and $3.2 billion as
of each of December 31, 2023, March 31, 2023, and December 31, 2022. The change in future policy benefits reserves year-to-date was primarily driven by benefit payments, as well as changes in the current discount rate. Undiscounted expected future policy benefits were $4.4 billion as of March 31, 2024 and $4.6 billion as of March 31, 2023. As of both March 31, 2024 and March 31, 2023, $1.0 billion of the future policy benefit reserve was recoverable through treaties with external reinsurers.
Contractholder Deposit Funds
Contractholder deposit fund liabilities within Other Operations were $6.5 billion as of March 31, 2024 and December 31, 2023 and $6.7 billion as of March 31, 2023 and December 31, 2022. Approximately 38% of the balance is reinsured externally. 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 March 31, 2024, the weighted average crediting rate, net amount at risk and cash surrender value for contractholder deposit fund liabilities not effectively exited through reinsurance were 3.33%, $3.0 billion and $2.8 billion, respectively. The comparative amounts as of March 31, 2023 were 3.25%, $3.2 billion and $2.8 billion, respectively. More than 99% of the $4.0 billion liability as of March 31, 2024 and the $4.1 billion liability as of March 31, 2023 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 March 31, 2024 and $1.7 billion as of March 31, 2023 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 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.
Market risk benefits activity was as follows:
Three Months Ended March 31,
(Dollars in millions)20242023
Balance, beginning of year$1,003 $1,268 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,085 1,379 
Changes due to expected run-off(3)(6)
Changes due to capital markets versus expected(113)(41)
Changes due to policyholder behavior versus expected(14)6 
Assumption changes— (33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)955 1,305 
Nonperformance risk (own credit risk), end of period(64)(85)
Balance, end of period$891 $1,220 
Reinsured market risk benefit, end of period$951 $1,301 
The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount 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. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements.
(Dollars in millions, excludes impact of reinsurance ceded)March 31, 2024March 31, 2023
Net amount at risk$1,441 $2,183 
Average attained age of contractholders (weighted by exposure)77.7 years75.4 years
v3.24.1.u1
Reinsurance
 3 Months Ended
Mar. 31, 2024
Reinsurance Disclosures [Abstract]  
Reinsurance
Note 10 – Reinsurance
The Company's insurance subsidiaries enter into agreements with other insurance companies to limit losses from large exposures and to permit recovery of a portion of incurred losses. Reinsurance is ceded primarily in acquisition and disposition transactions when the underwriting company is not being acquired. Reinsurance does not relieve the originating insurer of liability. Therefore, reinsured liabilities must continue to be reported along with the related reinsurance recoverables. The Company regularly evaluates the financial condition of its reinsurers and monitors concentrations of its credit risk.
Reinsurance Recoverables
The majority of the Company's reinsurance recoverables resulted from acquisition and disposition transactions in which the underwriting company was not acquired. 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. The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses.
The Company's reinsurance recoverables as of March 31, 2024 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 (1)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (2)
$— $— $85 $85 
BBB- to BBB+ equivalent current credit ratings (2)
— â€” 60 60 
Not rated145 7 188 340 
Total recoverables related to ongoing operations145 7 333 485 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York— 2,619 â€” 2,619 
Empower Annuity Insurance Company— â€” 128 128 
Prudential Insurance Company of America351 â€” â€” 351 
Life Insurance Company of North America— 334 â€” 334 
Other167 23 14 204 
Not rated— 6 4 10 
Total recoverables related to acquisition, disposition or run-off activities518 2,982 146 3,646 
Total reinsurance recoverables before market risk benefits$663 $2,989 $479 $4,131 
Allowance for uncollectible reinsurance(35)
Market risk benefits951 
Total reinsurance recoverables (3)
$5,047 
(1)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
(2)Certified by an NRSRO.
(3)Includes $166 million of current reinsurance recoverables that are reported in Other current assets and $209 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 9 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 March 31, 2024. 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)
March 31, 2024December 31, 2023
Collateral and Other Terms
at March 31, 2024
Berkshire$777 $873 
100% were secured by assets in a trust.
Sun Life Assurance Company of Canada79 92 
Liberty Re (Bermuda) Ltd.91 104 
100% were secured by assets in a trust.
SCOR SE27 31 
75% were secured by a letter of credit.
Market risk benefits (2)
$974 $1,100 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.

The impact of nonperformance risk (i.e., the risk that a counterparty might default) on the variable annuity reinsurance asset was immaterial for the three months ended March 31, 2024 and March 31, 2023.
v3.24.1.u1
Investments
 3 Months Ended
Mar. 31, 2024
Investments [Abstract]  
Investments
Note 11 – Investments
The Cigna Group's investment portfolio consists of a broad range of investments including debt securities, equity securities, commercial mortgage loans, policy loans, other long-term investments, short-term investments and derivative financial instruments. The sections below provide more detail regarding our investment balances and realized investment gains and losses. See Note 12 to the Consolidated Financial Statements for information about the valuation of the Company's investment portfolio. Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.
The following table summarizes the Company's investments by category and current or long-term classification:
March 31, 2024December 31, 2023
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$604 $8,876 $9,480 $590 $9,265 $9,855 
Equity securities18 1,553 1,571 31 3,331 3,362 
Commercial mortgage loans197 1,365 1,562 182 1,351 1,533 
Policy loans— 1,186 1,186 â€” 1,211 1,211 
Other long-term investments— 4,301 4,301 â€” 4,181 4,181 
Short-term investments374 â€” 374 206 â€” 206 
Total$1,193 $17,281 $18,474 $1,009 $19,339 $20,348 
Investments classified as assets of businesses held for sale (1)
(85)(1,256)(1,341)(84)(1,354)(1,438)
Investments per Consolidated Balance Sheets$1,108 $16,025 $17,133 $925 $17,985 $18,910 
(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024. 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
The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of March 31, 2024:
(In millions)Amortized
Cost		Fair
Value
Due in one year or less$633 $619 
Due after one year through five years3,768 3,587 
Due after five years through ten years3,144 2,921 
Due after ten years2,186 2,000 
Mortgage and other asset-backed securities389 353 
Total$10,120 $9,480 
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
March 31, 2024
Federal government and agency$289 $— $21 $(10)$300 
State and local government37 â€” 2 (1)38 
Foreign government354 â€” 8 (14)348 
Corporate9,051 (50)122 (682)8,441 
Mortgage and other asset-backed389 â€” â€” (36)353 
Total$10,120 $(50)$153 $(743)$9,480 
December 31, 2023
Federal government and agency$251 $— $24 $(8)$267 
State and local government37 â€” 2 (1)38 
Foreign government355 â€” 10 (13)352 
Corporate9,338 (33)158 (630)8,833 
Mortgage and other asset-backed398 â€” 1 (34)365 
Total$10,379 $(33)$195 $(686)$9,855 
Review of declines in fair value. Management reviews debt securities in an unrealized loss position 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.
March 31, 2024December 31, 2023
(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$562 $576 $(14)232$330 $338 $(8)142 
Below investment grade133 137 (4)253161 170 (9)135 
More than one year
Investment grade5,284 5,946 (662)1,5615,441 6,036 (595)1,590 
Below investment grade598 661 (63)367701 775 (74)486 
Total$6,577 $7,320 $(743)2,413 $6,633 $7,319 $(686)2,353 
Equity Securities
The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:
March 31, 2024 December 31, 2023
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$647 $39 $656 $51 
Equity securities with no readily determinable fair value3,281 1,532 3,248 3,311 
Total$3,928 $1,571 $3,904 $3,362 
We are a minority owner in VillageMD, 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. As of March 31, 2024, we determined our investment in VillageMD was impaired and wrote down the carrying value to an estimated fair value of $0.9 billion, resulting in a $1.8 billion loss recorded in Net realized investment losses in the Company's Consolidated Statements of Income.

Consistent with our strategy to invest in targeted startup and growth-stage companies in the health care industry, approximately 90% of our investments in equity securities are in the health care sector.
Commercial Mortgage Loans
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.
The Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.
The following table summarizes the credit risk profile of the Company's commercial mortgage loan portfolio:
(Dollars in millions)March 31, 2024December 31, 2023
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$810 2.12$802 2.13
60% to 79%594 1.75574 1.77
80% to 100%158 0.63157 0.65
Total$1,562 1.8164 %$1,533 1.8264 %
Other Long-Term Investments
Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. 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. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other. The following table provides the carrying value information for these investments:
Carrying Value as of
(In millions)March 31, 2024December 31, 2023
Real estate investments$1,696 $1,606 
Securities partnerships2,423 2,400 
Other182 175 
Total$4,301 $4,181 
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.
As of March 31, 2024, there have been no material changes to the Company's derivative financial instruments. Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies. The effects of derivative financial instruments used in our individual hedging strategies were not material to the Consolidated Financial Statements as of March 31, 2024 and December 31, 2023. The gross fair values of our derivative financial instruments are presented in Note 12 to the Consolidated Financial Statements.
Realized Investment Gains and LossesNet realized investment losses, before income taxes were $1,836 million for the three months ended March 31, 2024 and $56 million for the three months ended March 31, 2023. This increase was primarily driven by the impairment of equity securities in 2024. These amounts exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders.
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Fair Value Measurements
 3 Months Ended
Mar. 31, 2024
Fair Value Disclosures [Abstract]  
Fair Value Measurements
Note 12 – Fair Value Measurements
The Company carries certain financial instruments at fair value in the financial statements including debt securities, certain equity securities, short-term investments and derivatives. Other financial instruments are measured at fair value only under certain conditions, such as when impaired or when there are observable price changes for equity securities with no readily determinable fair value.
Fair value is defined as the price at which an asset could be exchanged in an orderly transaction between market participants at the balance sheet date. A liability's fair value is defined as the amount that would be paid to transfer the liability to a market participant, not the amount that would be paid to settle the liability with the creditor.
The Company's financial assets and liabilities carried at fair value have been classified based upon a hierarchy defined by GAAP. The hierarchy gives the highest ranking to fair values determined using unadjusted quoted prices in active markets for identical assets and liabilities (Level 1) and the lowest ranking to fair values determined using methodologies and models with unobservable inputs (Level 3). An asset's or a liability's classification is based on the lowest level of input that is significant to its measurement. For example, a financial asset or liability carried at fair value would be classified in Level 3 if unobservable inputs were significant to the instrument's fair value, even though the measurement may be derived using inputs that are both observable (Levels 1 and 2) and unobservable (Level 3).
For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K.
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 9E 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
March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency$165 $130 $135 $137 $— $— $300 $267 
State and local government— â€” 38 38 â€” â€” 38 38 
Foreign government— â€” 348 352 â€” â€” 348 352 
Corporate
— â€” 8,072 8,432 369 401 8,441 8,833 
Mortgage and other asset-backed— â€” 300 319 53 46 353 365 
Total debt securities165 130 8,893 9,278 422 447 9,480 9,855 
Equity securities (1)
2 4 37 47 â€” â€” 39 51 
Short-term investments— â€” 374 206 â€” â€” 374 206 
Derivative assets— â€” 147 131 â€” 1 147 132 
Financial liabilities at fair value
Derivative liabilities$— $— $4 $4 $— $— $4 $4 
(1)Excludes certain equity securities that have no readily determinable fair value.
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 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.
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)March 31, 2024December 31, 2023Unobservable Input March 31, 2024March 31, 2024December 31, 2023
Debt securities
Corporate$369 $401 Liquidity
55 - 1230 (280)
bps
70 - 1235 (310)
bps
Mortgage and other asset-backed securities53 46 Liquidity
110 - 605 (280)
bps
95 - 640 (310)
bps
Total Level 3 debt securities$422 $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.
Three Months Ended March 31,
(In millions)20242023
Debt and Equity Securities
Beginning balance$447 $447 
(Losses) gains included in Shareholders' net (loss) income
(21)1 
(Losses) gains included in Other comprehensive loss
(3)5 
Purchases, sales and settlements
Purchases— 4 
Settlements(14)(9)
Total purchases, sales and settlements(14)(5)
Transfers into/(out of) Level 3
Transfers into Level 316 39 
Transfers out of Level 3(3)(16)
Total transfers into/(out of) Level 313 23 
Ending balance$422 $471 
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date
$(21)$1 
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period
$(4)$5 

Total gains and losses included in Shareholders' net (loss) income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses 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 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 2024 and 2023 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
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. The separate account activity for the three months ended March 31, 2024 and 2023 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)March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023
Guaranteed separate accounts (See Note 16)
$230 $226 $339 $352 $— $— $569 $578 
Non-guaranteed separate accounts (1)
158 158 5,794 5,797 229 217 6,181 6,172 
Subtotal$388 $384 $6,133 $6,149 $229 $217 6,750 6,750 
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)
666 680 
Total$7,416 $7,430 
(1)Non-guaranteed separate accounts include $4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both March 31, 2024 and December 31, 2023.
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 three months ended March 31, 2024 or 2023.
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 March 31, 2024Redemption Frequency
(if currently eligible)		Redemption Notice
Period
(In millions)March 31, 2024December 31, 2023
Securities partnerships$412 $419 $252 Not applicableNot applicable
Real estate funds251 258 â€” Quarterly
30 - 90 days
Hedge funds3 3 â€” Up to annually, varying by fund
30 - 90 days
Total$666 $680 $252 
As of March 31, 2024, 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 three months ended March 31, 2024, our equity investment in VillageMD was written down to an estimated fair value of $0.9 billion resulting in an investment loss of $1.8 billion recorded in Net realized investment losses in the Company's Consolidated Statements of Income. For the three months ended March 31, 2023, impairments recognized requiring these assets to be measured at fair value were not material. Observable price changes for other equity securities with no readily determinable fair value were not material for the three months ended March 31, 2024 and March 31, 2023.
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 HierarchyMarch 31, 2024December 31, 2023
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,451 $1,562 $1,430 $1,533 
Long-term debt, including current maturities, excluding finance leasesLevel 2$29,806 $31,783 $28,033 $29,585 
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Variable Interest Entities
 3 Months Ended
Mar. 31, 2024
Variable Interest Entities [Abstract]  
Variable Interest Entities
Note 13 – Variable Interest Entities
We perform ongoing qualitative analyses of our involvement with variable interest entities to determine if consolidation is required. The Company determined that it was not a primary beneficiary in any material variable interest entity as of March 31, 2024 or December 31, 2023. The Company's involvement with variable interest entities for which it is not the primary beneficiary has not materially changed from December 31, 2023. For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K. The Company has not provided, and does not intend to provide, financial support to any of these variable interest entities in excess of its maximum exposure.
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Accumulated Other Comprehensive Income (Loss)
 3 Months Ended
Mar. 31, 2024
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Accumulated Other Comprehensive Income (Loss)
Note 14 – Accumulated Other Comprehensive Income (Loss)
Accumulated Other Comprehensive Income (Loss) ("AOCI") includes net unrealized appreciation on securities and derivatives, change in discount rate and instrument-specific credit risk for certain long-duration insurance contractholder liabilities (Note 9 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 (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.

Shareholders' other comprehensive loss, net of tax, for the three months ended March 31, 2024 and March 31, 2023, is primarily attributable to the change in discount rates for certain long-duration liabilities (following the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023) and unrealized changes in the market values of securities and derivatives, including the impacts from unconsolidated entities reported on the equity method.

Changes in the components of AOCI were as follows:
Three Months Ended March 31,
(In millions)20242023
Securities and Derivatives
Beginning balance$171 $(332)
Unrealized appreciation on securities and derivatives
143 252 
Tax (expense)
(39)(54)
Net unrealized appreciation on securities and derivatives
104 198 
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)
22 (5)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income
(5)1 
Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income
17 (4)
Other comprehensive income, net of tax
121 194 
Ending balance$292 $(138)
Three Months Ended March 31,
(In millions)20242023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance$(971)$(256)
Current period change in discount rate for certain long-duration liabilities(732)(411)
Tax benefit
186 101 
Net current period change in discount rate for certain long-duration liabilities(546)(310)
Current period change in instrument-specific credit risk for market risk benefits(18)(26)
Tax benefit
4 5 
Net current period change in instrument-specific credit risk for market risk benefits(14)(21)
Other comprehensive (loss), net of tax
(560)(331)
Ending balance$(1,531)$(587)

Three Months Ended March 31,
(In millions)20242023
Translation of foreign currencies
Beginning balance$(149)$(154)
Translation of foreign currencies(24)15 
Tax (expense) benefit
(2)1 
Other comprehensive (loss) income, net of tax
(26)16 
Ending balance$(175)$(138)

Three Months Ended March 31,
(In millions)20242023
Postretirement benefits liability
Beginning balance$(915)$(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)8 13 
Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income
(3)(3)
Other comprehensive income, net of tax5 10 
Ending balance$(910)$(906)

Three Months Ended March 31,
(In millions)20242023
Total Accumulated other comprehensive loss
Beginning balance$(1,864)$(1,658)
Shareholders' other comprehensive (loss), net of tax
(460)(111)
Ending balance$(2,324)$(1,769)
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Income Taxes
 3 Months Ended
Mar. 31, 2024
Income Tax Disclosure [Abstract]  
Income Taxes
Note 15 – Income Taxes
Income Tax Expense
The effective tax rate for the three months ended March 31, 2024 increased due to a valuation allowance related to the impairment of equity securities, partially offset by a decrease related to the businesses held for sale and a decrease related to the release of tax reserves following a favorable state audit resolution. The 368.4% effective tax rate for the three months ended March 31, 2024 was higher than the 18.4% rate for the three months ended March 31, 2023.
As of March 31, 2024, we had approximately $664 million in deferred tax assets ("DTAs") associated with the impairment of equity securities, as well as unrealized investment losses that are partially recorded in Accumulated other comprehensive loss. A valuation allowance of $427 million, which drove the higher effective tax rate, was established in the three months ended March 31, 2024, almost entirely related to the impairment of equity securities. For the remainder of the DTAs, we have determined that a valuation allowance 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 additional valuation allowance.
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Contingencies and Other Matters
 3 Months Ended
Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]  
Contingencies and Other Matters
Note 16 – 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 March 31, 2024, employers maintained assets that generally exceeded the benefit obligations under these arrangements of approximately $410 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 March 31, 2024. 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 March 31, 2024 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 recorded liabilities for these indemnification obligations as of March 31, 2024.
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 three months ended March 31, 2024.
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 services business. 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.
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 filed its opening appellate brief on April 24, 2024.
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Segment Information
 3 Months Ended
Mar. 31, 2024
Segment Reporting [Abstract]  
Segment Information
Note 17 – 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 (loss) from operations as income (loss) 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:
Three Months Ended March 31,
20242023
(In millions)Pre-taxAfter-taxPre-taxAfter-tax
Integration and transaction-related costs
 (Selling, general and administrative expenses)		$37 $29 $1 $1 
Loss (gain) on sale of businesses19 (43)— â€” 
Deferred tax expenses, net
 (Income taxes, less amount attributable to noncontrolling interests)		— 17 â€” â€” 
Total impact from special items$56 $3 $1 $1 
Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Three months ended March 31, 2024
Revenues from external customers$44,886 $12,012 $66 $1 $56,965 
Intersegment revenues1,281 1,124 25 (2,430)
Net investment income
59 149 75 7 290 
Total revenues46,226 13,285 166 (2,422)57,255 
Net realized investment results from certain equity method investments
— (8)— â€” (8)
Adjusted revenues$46,226 $13,277 $166 $(2,422)$57,247 
(Loss) income before income taxes
$(436)$943 $18 $(446)$79 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(77)— â€” â€” (77)
Net realized investment losses (1)
1,456 372 â€” â€” 1,828 
Amortization of acquired intangible assets417 6 â€” â€” 423 
Special items
Integration and transaction-related costs— â€” â€” 37 37 
Loss on sale of businesses— 19 â€” â€” 19 
Pre-tax adjusted income (loss) from operations$1,360 $1,340 $18 $(409)$2,309 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Three months ended March 31, 2023
Revenues from external customers
$34,511 $11,650 $79 $— $46,240 
Intersegment revenues1,618 963 â€” (2,581)
Net investment income
50 143 78 6 277 
Total revenues36,179 12,756 157 (2,575)46,517 
Net realized investment results from certain equity method investments— (38)— â€” (38)
Adjusted revenues$36,179 $12,718 $157 $(2,575)$46,479 
Income (loss) before income taxes
$918 $1,077 $21 $(415)$1,601 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(42)(1)— â€” (43)
Net realized investment losses (gains) (1)
— 24 (6)— 18 
Amortization of acquired intangible assets444 15 â€” â€” 459 
Special items
Integration and transaction-related costs— â€” â€” 1 1 
Pre-tax adjusted income (loss) from operations$1,320 $1,115 $15 $(414)$2,036 
(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as 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, which are presented within Fees and other revenues in our Consolidated Statements of Income.
Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:
Three Months Ended March 31,
(In millions)20242023
Products (Pharmacy revenues) (ASC 606)
Network revenues$24,166 $15,748 
Home delivery and specialty revenues16,458 16,025 
Other revenues2,546 1,867 
Total Evernorth Health Services
43,170 33,640 
Total Other Operations
17 â€” 
Intercompany eliminations(1,151)(1,496)
Total Pharmacy revenues
42,036 32,144 
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured4,393 4,080 
Medicare Advantage2,287 2,236 
Stop loss1,668 1,503 
Individual and Family Plans1,040 1,208 
Other1,258 1,117 
U.S. Healthcare
10,646 10,144 
International Health885 786 
Total Cigna Healthcare11,531 10,930 
Other48 79 
Intercompany eliminations24 16 
Total Premiums
11,603 11,025 
Services (Fees) (ASC 606)
Evernorth Health Services
2,943 2,499 
Cigna Healthcare
1,571 1,606 
Other Operations
25 1 
Other revenues90 66 
Intercompany eliminations(1,303)(1,101)
Total Fees and other revenues
3,326 3,071 
Total revenues from external customers$56,965 $46,240 
(1)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. Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.
Financial and performance guarantees. Evernorth Health Services 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 following the end of the annual guarantee period. Historically, adjustments to original estimates have not been material. This guarantee liability was $1.9 billion as of March 31, 2024 and $1.6 billion as of December 31, 2023.

Major customers. Revenues from a single pharmacy benefit client were approximately 15% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services segment.

Additionally, revenues from U.S. Federal Government agencies, under a number of contracts, were approximately 13% of consolidated revenues for the three months ended March 31, 2024. These amounts were reported in the Evernorth Health Services and Cigna Healthcare segments. See Note 25 in the Company's 2023 Form 10-K for prior year revenue concentration information.
v3.24.1.u1
Insider Trading Arrangements
 3 Months Ended
Mar. 31, 2024
shares
Trading Arrangements, by Individual  
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
Noelle Eder [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement On February 9, 2024, Noelle Eder, Executive Vice President, Global Chief Information Officer of The Cigna Group, adopted a 10b5-1 plan. Ms. Eder's plan provides for the sale of up to 8,179 shares of The Cigna Group common stock and the exercise of vested stock options and the associated sale of up to 6,408 shares of The Cigna Group common stock through February 28, 2025.
Name Noelle Eder
Title Executive Vice President, Global Chief Information Officer of The Cigna Group
Rule 10b5-1 Arrangement Adopted true
Adoption Date February 9, 2024
Arrangement Duration 385 days
Brian Evanko [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement On February 15, 2024, Brian Evanko, Executive Vice President, Chief Financial Officer of The Cigna Group and President and Chief Executive Officer, Cigna Healthcare, adopted a 10b5-1 plan. Mr. Evanko's plan provides for the exercise of vested stock options and the associated sale of up to 17,924 shares of The Cigna Group common stock through February 10, 2025.
Name Brian Evanko
Title Executive Vice President, Chief Financial Officer of The Cigna Group and President and Chief Executive Officer, Cigna Healthcare
Rule 10b5-1 Arrangement Adopted true
Adoption Date February 15, 2024
Arrangement Duration 361 days
Aggregate Available 17,924
Eric Palmer [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement On February 16, 2024, Eric Palmer, Executive Vice President, Enterprise Strategy of The Cigna Group and President and Chief Executive Officer, Evernorth Health Services, adopted a 10b5-1 plan. Mr. Palmer's plan provides for the sale of up to 4,993 shares of The Cigna Group common stock and the exercise of vested stock options and the associated sale of up to 17,530 shares of The Cigna Group common stock through February 10, 2025.
Name Eric Palmer
Title Executive Vice President, Enterprise Strategy of The Cigna Group and President and Chief Executive Officer, Evernorth Health Services
Rule 10b5-1 Arrangement Adopted true
Adoption Date February 16, 2024
Arrangement Duration 360 days
Elder Granger [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement On March 13, 2024, Elder Granger, Director, adopted a 10b5-1 plan. Mr. Granger's plan provides for the exercise of vested stock options and the associated sale of up to 1,547 shares of The Cigna Group common stock through September 16, 2024.
Name Elder Granger
Title Director
Rule 10b5-1 Arrangement Adopted true
Adoption Date March 13, 2024
Arrangement Duration 187 days
Aggregate Available 1,547
Noelle Eder Trading Arrangement, Common Stock [Member] | Noelle Eder [Member]  
Trading Arrangements, by Individual  
Aggregate Available 8,179
Noelle Eder Trading Arrangement, Stock Options [Member] | Noelle Eder [Member]  
Trading Arrangements, by Individual  
Aggregate Available 6,408
Eric Palmer Trading Arrangement, Common Stock [Member] | Eric Palmer [Member]  
Trading Arrangements, by Individual  
Aggregate Available 4,993
Eric PalmerTrading Arrangement, Stock Options [Member] | Eric Palmer [Member]  
Trading Arrangements, by Individual  
Aggregate Available 17,530
v3.24.1.u1
Summary of Significant Accounting Policies (Policies)
 3 Months Ended
Mar. 31, 2024
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").
Amounts recorded in the Consolidated Financial Statements necessarily reflect management's estimates and assumptions about medical costs, investment, tax 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.
These interim Consolidated Financial Statements are unaudited but include all adjustments (including normal recurring adjustments) necessary, in the opinion of management, for a fair statement of financial position and results of operations for the periods reported. The interim Consolidated Financial Statements and Notes should be read in conjunction with the Consolidated Financial Statements and Notes included in the 2023 Annual Report on Form 10-K ("2023 Form 10-K"). The preparation of interim Consolidated Financial Statements necessarily relies heavily on estimates. This and other factors, including the seasonal nature of portions of the health care and related benefits business, as well as competitive and other market conditions, call for caution in estimating full-year results based on interim results of operations.
Recent Accounting Pronouncements, Recently Adopted Accounting Guidance and Accounting Guidance Not Yet Adopted
Recent Accounting Pronouncements
The Company's 2023 Form 10-K includes discussion of significant recent accounting pronouncements that either have impacted or may impact our financial statements in the future. There are no updates on significant accounting pronouncements recently adopted or recently issued and not yet adopted that have occurred since the Company filed its 2023 Form 10-K.
Revenue Recognition Evernorth Health Services 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 following the end of the annual guarantee period.
Accounts Receivable The Company maintains an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution.As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.
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.
Future Policy Benefits 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.
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.
Reinsurance
Reinsurance and other amounts recoverable reflect amounts due from reinsurers and policyholders to cover incurred but not reported and pending claims of certain business for which the Company administers the plan benefits without any right of offset. See Note 10 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.
The Company reviews its reinsurance arrangements and establishes reserves against the recoverables primarily for expected credit losses.
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 9 to the Consolidated Financial Statements.
Investments Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.
Review of declines in fair value. Management reviews debt securities in an unrealized loss position 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 Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.
Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. 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. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other.
Derivative Financial Instruments Please refer to the Company's 2023 Form 10-K for further discussion of the types of derivative financial instruments and associated accounting policies.
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).
For a description of the policies, methods and assumptions that are used to estimate fair value and determine the fair value hierarchy for each class of financial instruments, see Note 13 in the Company's 2023 Form 10-K.
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 9E to the Consolidated Financial Statements, the Company classifies variable annuity assets and liabilities in Level 3 of the fair value hierarchy.
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 (loss) income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses 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 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
Separate Accounts
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. The separate account activity for the three months ended March 31, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account 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 For details of our accounting policy for variable interest entities and the composition of variable interest entities with which the Company is involved, refer to Note 14 in the Company's 2023 Form 10-K.
AOCI Generally, tax effects in AOCI are established at the currently enacted tax rate and reclassified to Shareholders' net (loss) income in the same period that the related pre-tax AOCI reclassifications are recognized.
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 March 31, 2024 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 (loss) from operations as income (loss) 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.
v3.24.1.u1
Receivables, Loans, Notes Receivable, and Others (Policies)
 3 Months Ended
Mar. 31, 2024
Receivables [Abstract]  
Accounts Receivable The Company maintains an uncommitted factoring facility (the "Facility") under which certain accounts receivable may be sold on a non-recourse basis to a financial institution.As of March 31, 2024, there were $93 million of sold accounts receivable that have not been collected from manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from manufacturers. As of March 31, 2024 and December 31, 2023, there were $722 million and $515 million, respectively, of collections from manufacturers that have not been remitted to the financial institution. Such amounts are recorded within Accrued expenses and other liabilities in the Consolidated Balance Sheets.
v3.24.1.u1
Investments, Debt and Equity Securities (Policies)
 3 Months Ended
Mar. 31, 2024
Investments, Debt and Equity Securities [Abstract]  
Investments Further information about our accounting policies for investment assets can be found in Note 12 in the Company's 2023 Form 10-K.
Review of declines in fair value. Management reviews debt securities in an unrealized loss position 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 Company regularly evaluates and monitors credit risk from the initial mortgage loan underwriting and throughout the investment holding period. For more information on the Company's accounting policies and methodologies regarding these investments, see Note 12 in the Company's 2023 Form 10-K.
Other long-term investments include investments in unconsolidated entities, including certain limited partnerships and limited liability companies holding real estate, securities or loans. 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. Additionally, statutory and other restricted deposits and foreign currency swaps carried at fair value are reported in the table below as Other.
v3.24.1.u1
Accounts Receivable, Net (Tables)
 3 Months Ended
Mar. 31, 2024
Receivables [Abstract]  
Accounts Receivable, Net
The following amounts were included within Accounts receivable, net:
(In millions)March 31, 2024December 31, 2023
Noninsurance customer receivables$9,735 $8,044 
Pharmaceutical manufacturers receivables9,512 8,169 
Insurance customer receivables2,045 2,359 
Other receivables230 272 
Total$21,522 $18,844 
Accounts receivable, net classified as assets of businesses held for sale
(959)(1,122)
Total$20,563 $17,722 
v3.24.1.u1
Assets and Liabilities of Businesses Held for Sale (Tables)
 3 Months Ended
Mar. 31, 2024
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)March 31, 2024December 31, 2023
Cash and cash equivalents$1,660 $467 
Investments1,341 1,438 
Accounts receivable, net959 1,122 
Other assets, including Goodwill (1)
2,394 2,963 
Total assets of businesses held for sale6,354 5,990 
Insurance and contractholder liabilities2,081 1,636 
All other liabilities1,134 1,059 
Total liabilities of businesses held for sale$3,215 $2,695 
(1) Includes Goodwill of $396 million as of March 31, 2024 and December 31, 2023.
v3.24.1.u1
Earnings Per Share (Tables)
 3 Months Ended
Mar. 31, 2024
Earnings Per Share [Abstract]  
Computation of Basic and Diluted Earnings Per Share
Basic and diluted earnings per share were computed as follows:
Three Months Ended
March 31, 2024March 31, 2023
(Shares in thousands, dollars in millions, except per share amounts)BasicEffect of
Dilution		DilutedBasicEffect of
Dilution		Diluted
Shareholders' net (loss) income
$(277)$(277)$1,267 $1,267 
Shares:
Weighted average286,465 286,465 295,706 295,706 
Common stock equivalents— â€” 3,293 3,293 
Total shares286,465 â€” 286,465 295,706 3,293 298,999 
Earnings per share$(0.97)$— $(0.97)$4.28 $(0.04)$4.24 
v3.24.1.u1
Debt (Tables)
 3 Months Ended
Mar. 31, 2024
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)March 31, 2024December 31, 2023
Short-term debt
Commercial paper$884 $1,237 
$500 million, 0.613% Notes due March 2024
— 500 
$790 million, 3.500% Notes due June 2024 (1)
789 996 
Other, including finance leases42 42 
Total short-term debt$1,715 $2,775 
Long-term debt
$900 million, 3.250% Notes due April 2025 (2)
881 882 
$1,216 million, 4.125% Notes due November 2025 (1)
1,214 2,197 
$1,284 million, 4.500% Notes due February 2026 (1)
1,285 1,502 
$550 million, 1.250% Notes due March 2026 (1)
549 798 
$700 million, 5.685% Notes due March 2026
698 698 
$1,500 million, 3.400% Notes due March 2027
1,454 1,450 
$259 million, 7.875% Debentures due May 2027
259 259 
$600 million, 3.050% Notes due October 2027
598 597 
$3,800 million, 4.375% Notes due October 2028
3,788 3,787 
$1,000 million, 5.000% Notes due May 2029
994 â€” 
$1,400 million, 2.400% Notes due March 2030 (1)
1,394 1,493 
$1,500 million, 2.375% Notes due March 2031 (2)
1,382 1,397 
$750 million, 5.125% Notes due May 2031
745 â€” 
$45 million, 8.080% Step Down Notes due January 2033 (3)
45 45 
$800 million, 5.400% Notes due March 2033
794 794 
$1,250 million, 5.250% Notes due February 2034
1,242 â€” 
$190 million, 6.150% Notes due November 2036
190 190 
$2,200 million, 4.800% Notes due August 2038
2,193 2,193 
$750 million, 3.200% Notes due March 2040
744 744 
$121 million, 5.875% Notes due March 2041
119 119 
$448 million, 6.125% Notes due November 2041
487 487 
$317 million, 5.375% Notes due February 2042
315 315 
$1,500 million, 4.800% Notes due July 2046
1,467 1,467 
$1,000 million, 3.875% Notes due October 2047
989 989 
$3,000 million, 4.900% Notes due December 2048
2,970 2,970 
$1,250 million, 3.400% Notes due March 2050
1,237 1,237 
$1,500 million, 3.400% Notes due March 2051
1,479 1,479 
$1,500 million, 5.600% Notes due February 2054
1,482 â€” 
Other, including finance leases59 66 
Total long-term debt$31,053 $28,155 
(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 11 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
Debt Issuance and Debt Tender Offers. In February 2024, we issued $4.5 billion of new senior notes, as detailed in the table below. The proceeds from this debt were used to pay the consideration for the cash tender offers as described below. We used the remaining net proceeds to fund the repayment of our senior notes which matured in March 2024 and for general corporate purposes, including repayment of indebtedness and repurchases of shares of our common stock. Interest on this debt is paid semi-annually.

PrincipalMaturity DateInterest RateNet Proceeds
$1,000 million (1)
May 15, 20295.000%$995 million
$750 million (2)
May 15, 20315.125%$746 million
$1,250 million (3)
February 15, 20345.250%$1,244 million
$1,500 million (4)
February 15, 20545.600%$1,485 million
(1) Redeemable at any time prior to April 15, 2029 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after April 15, 2029.
(2) Redeemable at any time prior to March 15, 2031 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 15 basis points. Redeemable at par on or after March 15, 2031.
(3) Redeemable at any time prior to November 15, 2033 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after November 15, 2033.
(4) Redeemable at any time prior to August 15, 2053 at a "make whole" premium calculated using the most directly comparable U.S. Treasury rate plus 20 basis points. Redeemable at par on or after August 15, 2053.
v3.24.1.u1
Common and Preferred Stock (Tables)
 3 Months Ended
Mar. 31, 2024
Equity [Abstract]  
Dividend Payments
The following table provides details of the Company's dividend payments:
Record DatePayment DateAmount per Share
Total Amount Paid (in millions)
2024
March 6, 2024March 21, 2024$1.40$401
2023
March 8, 2023March 23, 2023$1.23$368
v3.24.1.u1
Insurance and Contractholder Liabilities (Tables)
 3 Months Ended
Mar. 31, 2024
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:
March 31, 2024December 31, 2023March 31, 2023
(In millions)CurrentNon-currentTotalCurrentNon-currentTotalTotal
Unpaid claims and claim expenses
Cigna Healthcare
$5,786 $77 $5,863 $5,017 $75 $5,092 $4,959 
Other Operations99 161 260 99 154 253 272 
Future policy benefits
Cigna Healthcare
92 515 607 97 518 615 601 
Other Operations163 3,297 3,460 163 3,375 3,538 3,631 
Contractholder deposit funds
Cigna Healthcare
11 130 141 12 133 145 163 
Other Operations365 6,087 6,452 362 6,178 6,540 6,670 
Market risk benefits26 865 891 37 966 1,003 1,220 
Unearned premiums815 21 836 846 22 868 1,440 
Total7,357 11,153 18,510 6,633 11,421 18,054 
Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1)
(1,569)(512)(2,081)(1,119)(517)(1,636)
Total insurance and contractholder liabilities$5,788 $10,641 $16,429 $5,514 $10,904 $16,418 $18,956 
(1) Amounts classified as liabilities of businesses held for sale include $1,378 million of Unpaid claims, $427 million of Future policy benefits, $161 million of Unearned premiums and $115 million of Contractholder deposit funds as of March 31, 2024 and $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:
Three Months Ended March 31,
(In millions)
2024 (1)
2023
Beginning balance$5,092 $4,176 
Less: Reinsurance and other amounts recoverable236 221 
Beginning balance, net4,856 3,955 
Incurred costs related to:
Current year9,452 9,041 
Prior years(226)(144)
Total incurred9,226 8,897 
Paid costs related to:
Current year5,072 5,316 
Prior years3,352 2,795 
Total paid8,424 8,111 
Ending balance, net5,658 4,741 
Add: Reinsurance and other amounts recoverable205 218 
Ending balance$5,863 $4,959 
(1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of March 31, 2024 and December 31, 2023, $1,378 million and $823 million classified as liabilities of businesses held for sale, respectively.
Variances in Incurred Costs Related to Prior Years' Unpaid Claims and Claims Expenses
Variances in incurred costs related to prior years' unpaid claims and claim expenses that resulted from the differences between actual experience and the Company's key assumptions were as follows:
Three Months Ended March 31,
20242023
(Dollars in millions)$
% (1)
$
% (2)
Actual completion factors$76 0.2 %$1 â€” %
Medical cost trend150 0.4 143 0.5 
Total favorable variance$226 0.6 %$144 0.5 %
(1)Percentage of current year incurred costs as reported for the year ended December 31, 2023.
(2)Percentage of current year incurred costs as reported for the year ended December 31, 2022.
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
March 31, 2024March 31, 2023
Interest accretion rate 2.56 %2.59 %
Current discount rate 5.11 %5.29 %
Weighted average duration 7.8 years8.1 years
The present values of expected net premiums and expected future policy benefits for the Cigna Healthcare segment were as follows:
Three Months Ended March 31,
(In millions)
2024 (1)
2023
Present value of expected net premiums
Beginning balance$9,233 $8,557 
Reversal of effect of beginning of period discount rate assumptions1,154 1,537 
Issuances and lapses 446 306 
Net premiums collected(350)(326)
Interest and other (2)
73 56 
Ending balance at original discount rate10,556 10,130 
Effect of end of period discount rate assumptions(1,309)(1,312)
Ending balance (3)
$9,247 $8,818 
Present value of expected policy benefits
Beginning balance$9,633 $8,945 
Reversal of effect of discount rate assumptions1,220 1,611 
Issuances and lapses 457 307 
Benefit payments(362)(326)
Interest and other (2)
71 58 
Ending balance at original discount rate11,019 10,595 
Effect of discount rate assumptions(1,381)(1,378)
Ending balance (4)
$9,638 $9,217 
Liability for future policy benefits $391 $399 
Other (5)
216 202 
Total liability for future policy benefits (6)(7)
$607 $601 
(1)Includes future policy benefits amounts classified as liabilities of businesses held for sale.
(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 March 31, 2024 and March 31, 2023 undiscounted expected future gross premiums were $19.0 billion and $17.6 billion, respectively. As of March 31, 2024 and March 31, 2023 discounted expected future gross premiums were $13.3 billion and $12.5 billion, respectively.
(4)As of March 31, 2024 and March 31, 2023, undiscounted expected future policy benefits were $13.6 billion and $12.8 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 $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of March 31, 2024 and March 31, 2023, respectively, relate to the liability for future policy benefits. Additionally, $81 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.
(7)Includes $427 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of March 31, 2024.
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
March 31, 2024March 31, 2023
Interest accretion rate 5.64 %5.64 %
Current discount rate 5.16 %4.95 %
Weighted average duration 11.3 years11.7 years
Summary of Market Risk Benefit
Market risk benefits activity was as follows:
Three Months Ended March 31,
(Dollars in millions)20242023
Balance, beginning of year$1,003 $1,268 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,085 1,379 
Changes due to expected run-off(3)(6)
Changes due to capital markets versus expected(113)(41)
Changes due to policyholder behavior versus expected(14)6 
Assumption changes— (33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)955 1,305 
Nonperformance risk (own credit risk), end of period(64)(85)
Balance, end of period$891 $1,220 
Reinsured market risk benefit, end of period$951 $1,301 
(In millions)
Reinsurer (1)
March 31, 2024December 31, 2023
Collateral and Other Terms
at March 31, 2024
Berkshire$777 $873 
100% were secured by assets in a trust.
Sun Life Assurance Company of Canada79 92 
Liberty Re (Bermuda) Ltd.91 104 
100% were secured by assets in a trust.
SCOR SE27 31 
75% were secured by a letter of credit.
Market risk benefits (2)
$974 $1,100 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.
Account Value, Net Amount at Risk and the Number of Contractholders for Guarantees Assumed in the Event of Death
The following table presents the net amount at risk and the average attained age of contractholders (weighted by exposure) for contracts assumed by the Company. The net amount at risk is the amount 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. The Company should be reimbursed in full for these payments unless the Berkshire reinsurance limit is exceeded, as discussed further in Note 10 to the Consolidated Financial Statements.
(Dollars in millions, excludes impact of reinsurance ceded)March 31, 2024March 31, 2023
Net amount at risk$1,441 $2,183 
Average attained age of contractholders (weighted by exposure)77.7 years75.4 years
v3.24.1.u1
Reinsurance (Tables)
 3 Months Ended
Mar. 31, 2024
Reinsurance Disclosures [Abstract]  
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level
The Company's reinsurance recoverables as of March 31, 2024 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 (1)
No collateralTotal
Ongoing Operations
A- equivalent and higher current ratings (2)
$— $— $85 $85 
BBB- to BBB+ equivalent current credit ratings (2)
— â€” 60 60 
Not rated145 7 188 340 
Total recoverables related to ongoing operations145 7 333 485 
Acquisition, disposition or run-off activities
BBB+ equivalent and higher current ratings (2)
Lincoln National Life and Lincoln Life & Annuity of New York— 2,619 â€” 2,619 
Empower Annuity Insurance Company— â€” 128 128 
Prudential Insurance Company of America351 â€” â€” 351 
Life Insurance Company of North America— 334 â€” 334 
Other167 23 14 204 
Not rated— 6 4 10 
Total recoverables related to acquisition, disposition or run-off activities518 2,982 146 3,646 
Total reinsurance recoverables before market risk benefits$663 $2,989 $479 $4,131 
Allowance for uncollectible reinsurance(35)
Market risk benefits951 
Total reinsurance recoverables (3)
$5,047 
(1)Includes collateral provisions requiring the reinsurer to fully collateralize its obligation if its external credit rating is downgraded to a specified level.
(2)Certified by an NRSRO.
(3)Includes $166 million of current reinsurance recoverables that are reported in Other current assets and $209 million of reinsurance recoverables classified as assets of businesses held for sale.
Reinsurance Recoverables for Variable Annuity Business
Market risk benefits activity was as follows:
Three Months Ended March 31,
(Dollars in millions)20242023
Balance, beginning of year$1,003 $1,268 
Balance, beginning of year, before the effect of nonperformance risk (own credit risk)1,085 1,379 
Changes due to expected run-off(3)(6)
Changes due to capital markets versus expected(113)(41)
Changes due to policyholder behavior versus expected(14)6 
Assumption changes— (33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)955 1,305 
Nonperformance risk (own credit risk), end of period(64)(85)
Balance, end of period$891 $1,220 
Reinsured market risk benefit, end of period$951 $1,301 
(In millions)
Reinsurer (1)
March 31, 2024December 31, 2023
Collateral and Other Terms
at March 31, 2024
Berkshire$777 $873 
100% were secured by assets in a trust.
Sun Life Assurance Company of Canada79 92 
Liberty Re (Bermuda) Ltd.91 104 
100% were secured by assets in a trust.
SCOR SE27 31 
75% were secured by a letter of credit.
Market risk benefits (2)
$974 $1,100 
(1)All reinsurers are rated A- equivalent and higher by an NRSRO.
(2)Includes incurred but not reported ("IBNR") and outstanding claims of $23 million as of March 31, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits at of March 31, 2024 in Note 9 and Note 10A to the Consolidated Financial Statements.
v3.24.1.u1
Investments (Tables)
 3 Months Ended
Mar. 31, 2024
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:
March 31, 2024December 31, 2023
(In millions)CurrentLong-termTotalCurrentLong-termTotal
Debt securities$604 $8,876 $9,480 $590 $9,265 $9,855 
Equity securities18 1,553 1,571 31 3,331 3,362 
Commercial mortgage loans197 1,365 1,562 182 1,351 1,533 
Policy loans— 1,186 1,186 â€” 1,211 1,211 
Other long-term investments— 4,301 4,301 â€” 4,181 4,181 
Short-term investments374 â€” 374 206 â€” 206 
Total$1,193 $17,281 $18,474 $1,009 $19,339 $20,348 
Investments classified as assets of businesses held for sale (1)
(85)(1,256)(1,341)(84)(1,354)(1,438)
Investments per Consolidated Balance Sheets$1,108 $16,025 $17,133 $925 $17,985 $18,910 
(1) Investments related to the HCSC transaction that were held for sale as of March 31, 2024. 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 March 31, 2024:
(In millions)Amortized
Cost		Fair
Value
Due in one year or less$633 $619 
Due after one year through five years3,768 3,587 
Due after five years through ten years3,144 2,921 
Due after ten years2,186 2,000 
Mortgage and other asset-backed securities389 353 
Total$10,120 $9,480 
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
March 31, 2024
Federal government and agency$289 $— $21 $(10)$300 
State and local government37 â€” 2 (1)38 
Foreign government354 â€” 8 (14)348 
Corporate9,051 (50)122 (682)8,441 
Mortgage and other asset-backed389 â€” â€” (36)353 
Total$10,120 $(50)$153 $(743)$9,480 
December 31, 2023
Federal government and agency$251 $— $24 $(8)$267 
State and local government37 â€” 2 (1)38 
Foreign government355 â€” 10 (13)352 
Corporate9,338 (33)158 (630)8,833 
Mortgage and other asset-backed398 â€” 1 (34)365 
Total$10,379 $(33)$195 $(686)$9,855 
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.
March 31, 2024December 31, 2023
(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$562 $576 $(14)232$330 $338 $(8)142 
Below investment grade133 137 (4)253161 170 (9)135 
More than one year
Investment grade5,284 5,946 (662)1,5615,441 6,036 (595)1,590 
Below investment grade598 661 (63)367701 775 (74)486 
Total$6,577 $7,320 $(743)2,413 $6,633 $7,319 $(686)2,353 
Equity Security Investments
The following table provides the values of the Company's equity security investments as of March 31, 2024 and December 31, 2023:
March 31, 2024 December 31, 2023
(In millions) CostCarrying Value CostCarrying Value
Equity securities with readily determinable fair values$647 $39 $656 $51 
Equity securities with no readily determinable fair value3,281 1,532 3,248 3,311 
Total$3,928 $1,571 $3,904 $3,362 
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)March 31, 2024December 31, 2023
Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value RatioCarrying ValueAverage Debt Service Coverage RatioAverage Loan-to-Value Ratio
Below 60%$810 2.12$802 2.13
60% to 79%594 1.75574 1.77
80% to 100%158 0.63157 0.65
Total$1,562 1.8164 %$1,533 1.8264 %
Carrying Value Information for Other Long-Term Investments The following table provides the carrying value information for these investments:
Carrying Value as of
(In millions)March 31, 2024December 31, 2023
Real estate investments$1,696 $1,606 
Securities partnerships2,423 2,400 
Other182 175 
Total$4,301 $4,181 
v3.24.1.u1
Fair Value Measurements (Tables)
 3 Months Ended
Mar. 31, 2024
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 9E 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
March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023
Financial assets at fair value
Debt securities
Federal government and agency$165 $130 $135 $137 $— $— $300 $267 
State and local government— â€” 38 38 â€” â€” 38 38 
Foreign government— â€” 348 352 â€” â€” 348 352 
Corporate
— â€” 8,072 8,432 369 401 8,441 8,833 
Mortgage and other asset-backed— â€” 300 319 53 46 353 365 
Total debt securities165 130 8,893 9,278 422 447 9,480 9,855 
Equity securities (1)
2 4 37 47 â€” â€” 39 51 
Short-term investments— â€” 374 206 â€” â€” 374 206 
Derivative assets— â€” 147 131 â€” 1 147 132 
Financial liabilities at fair value
Derivative liabilities$— $— $4 $4 $— $— $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)March 31, 2024December 31, 2023Unobservable Input March 31, 2024March 31, 2024December 31, 2023
Debt securities
Corporate$369 $401 Liquidity
55 - 1230 (280)
bps
70 - 1235 (310)
bps
Mortgage and other asset-backed securities53 46 Liquidity
110 - 605 (280)
bps
95 - 640 (310)
bps
Total Level 3 debt securities$422 $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.
Three Months Ended March 31,
(In millions)20242023
Debt and Equity Securities
Beginning balance$447 $447 
(Losses) gains included in Shareholders' net (loss) income
(21)1 
(Losses) gains included in Other comprehensive loss
(3)5 
Purchases, sales and settlements
Purchases— 4 
Settlements(14)(9)
Total purchases, sales and settlements(14)(5)
Transfers into/(out of) Level 3
Transfers into Level 316 39 
Transfers out of Level 3(3)(16)
Total transfers into/(out of) Level 313 23 
Ending balance$422 $471 
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date
$(21)$1 
Change in unrealized gain or (loss) included in Other comprehensive loss for assets held at the end of the reporting period
$(4)$5 
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)March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023March 31, 2024December 31, 2023
Guaranteed separate accounts (See Note 16)
$230 $226 $339 $352 $— $— $569 $578 
Non-guaranteed separate accounts (1)
158 158 5,794 5,797 229 217 6,181 6,172 
Subtotal$388 $384 $6,133 $6,149 $229 $217 6,750 6,750 
Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1)
666 680 
Total$7,416 $7,430 
(1)Non-guaranteed separate accounts include $4.0 billion as of both March 31, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both March 31, 2024 and December 31, 2023.
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 March 31, 2024Redemption Frequency
(if currently eligible)		Redemption Notice
Period
(In millions)March 31, 2024December 31, 2023
Securities partnerships$412 $419 $252 Not applicableNot applicable
Real estate funds251 258 â€” Quarterly
30 - 90 days
Hedge funds3 3 â€” Up to annually, varying by fund
30 - 90 days
Total$666 $680 $252 
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 HierarchyMarch 31, 2024December 31, 2023
(In millions)Fair ValueCarrying ValueFair ValueCarrying Value
Commercial mortgage loansLevel 3$1,451 $1,562 $1,430 $1,533 
Long-term debt, including current maturities, excluding finance leasesLevel 2$29,806 $31,783 $28,033 $29,585 
v3.24.1.u1
Accumulated Other Comprehensive Income (Loss) (Tables)
 3 Months Ended
Mar. 31, 2024
Accumulated Other Comprehensive Income (Loss), Net of Tax [Abstract]  
Changes in the Components of AOCI
Changes in the components of AOCI were as follows:
Three Months Ended March 31,
(In millions)20242023
Securities and Derivatives
Beginning balance$171 $(332)
Unrealized appreciation on securities and derivatives
143 252 
Tax (expense)
(39)(54)
Net unrealized appreciation on securities and derivatives
104 198 
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)
22 (5)
Reclassification adjustment for tax (benefit) expense included in Shareholders' net (loss) income
(5)1 
Net losses (gains) reclassified from AOCI to Shareholders' net (loss) income
17 (4)
Other comprehensive income, net of tax
121 194 
Ending balance$292 $(138)
Three Months Ended March 31,
(In millions)20242023
Net long-duration insurance and contractholder liabilities measurement adjustments
Beginning balance$(971)$(256)
Current period change in discount rate for certain long-duration liabilities(732)(411)
Tax benefit
186 101 
Net current period change in discount rate for certain long-duration liabilities(546)(310)
Current period change in instrument-specific credit risk for market risk benefits(18)(26)
Tax benefit
4 5 
Net current period change in instrument-specific credit risk for market risk benefits(14)(21)
Other comprehensive (loss), net of tax
(560)(331)
Ending balance$(1,531)$(587)

Three Months Ended March 31,
(In millions)20242023
Translation of foreign currencies
Beginning balance$(149)$(154)
Translation of foreign currencies(24)15 
Tax (expense) benefit
(2)1 
Other comprehensive (loss) income, net of tax
(26)16 
Ending balance$(175)$(138)

Three Months Ended March 31,
(In millions)20242023
Postretirement benefits liability
Beginning balance$(915)$(916)
Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other)8 13 
Reclassification adjustment for tax (benefit) included in Shareholders' net (loss) income
(3)(3)
Other comprehensive income, net of tax5 10 
Ending balance$(910)$(906)

Three Months Ended March 31,
(In millions)20242023
Total Accumulated other comprehensive loss
Beginning balance$(1,864)$(1,658)
Shareholders' other comprehensive (loss), net of tax
(460)(111)
Ending balance$(2,324)$(1,769)
v3.24.1.u1
Segment Information (Tables)
 3 Months Ended
Mar. 31, 2024
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:
Three Months Ended March 31,
20242023
(In millions)Pre-taxAfter-taxPre-taxAfter-tax
Integration and transaction-related costs
 (Selling, general and administrative expenses)		$37 $29 $1 $1 
Loss (gain) on sale of businesses19 (43)— â€” 
Deferred tax expenses, net
 (Income taxes, less amount attributable to noncontrolling interests)		— 17 â€” â€” 
Total impact from special items$56 $3 $1 $1 
Summarized Segment Financial Information
Summarized segment financial information was as follows:
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Three months ended March 31, 2024
Revenues from external customers$44,886 $12,012 $66 $1 $56,965 
Intersegment revenues1,281 1,124 25 (2,430)
Net investment income
59 149 75 7 290 
Total revenues46,226 13,285 166 (2,422)57,255 
Net realized investment results from certain equity method investments
— (8)— â€” (8)
Adjusted revenues$46,226 $13,277 $166 $(2,422)$57,247 
(Loss) income before income taxes
$(436)$943 $18 $(446)$79 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(77)— â€” â€” (77)
Net realized investment losses (1)
1,456 372 â€” â€” 1,828 
Amortization of acquired intangible assets417 6 â€” â€” 423 
Special items
Integration and transaction-related costs— â€” â€” 37 37 
Loss on sale of businesses— 19 â€” â€” 19 
Pre-tax adjusted income (loss) from operations$1,360 $1,340 $18 $(409)$2,309 
(In millions)
Evernorth Health Services
Cigna Healthcare
Other Operations
Corporate and Eliminations
Total
Three months ended March 31, 2023
Revenues from external customers
$34,511 $11,650 $79 $— $46,240 
Intersegment revenues1,618 963 â€” (2,581)
Net investment income
50 143 78 6 277 
Total revenues36,179 12,756 157 (2,575)46,517 
Net realized investment results from certain equity method investments— (38)— â€” (38)
Adjusted revenues$36,179 $12,718 $157 $(2,575)$46,479 
Income (loss) before income taxes
$918 $1,077 $21 $(415)$1,601 
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) attributable to noncontrolling interests
(42)(1)— â€” (43)
Net realized investment losses (gains) (1)
— 24 (6)— 18 
Amortization of acquired intangible assets444 15 â€” â€” 459 
Special items
Integration and transaction-related costs— â€” â€” 1 1 
Pre-tax adjusted income (loss) from operations$1,320 $1,115 $15 $(414)$2,036 
(1)Includes Net realized investment losses as presented in our Consolidated Statements of Income, as well as 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, which are presented within Fees and other revenues in our Consolidated Statements of Income.
Revenue from External Customers
Revenue from external customers includes Pharmacy revenues, Premiums and Fees and other revenues. The following table presents these revenues by product, premium and service type:
Three Months Ended March 31,
(In millions)20242023
Products (Pharmacy revenues) (ASC 606)
Network revenues$24,166 $15,748 
Home delivery and specialty revenues16,458 16,025 
Other revenues2,546 1,867 
Total Evernorth Health Services
43,170 33,640 
Total Other Operations
17 â€” 
Intercompany eliminations(1,151)(1,496)
Total Pharmacy revenues
42,036 32,144 
Insurance premiums (ASC 944)
Cigna Healthcare (1)
U.S. Healthcare
Employer insured4,393 4,080 
Medicare Advantage2,287 2,236 
Stop loss1,668 1,503 
Individual and Family Plans1,040 1,208 
Other1,258 1,117 
U.S. Healthcare
10,646 10,144 
International Health885 786 
Total Cigna Healthcare11,531 10,930 
Other48 79 
Intercompany eliminations24 16 
Total Premiums
11,603 11,025 
Services (Fees) (ASC 606)
Evernorth Health Services
2,943 2,499 
Cigna Healthcare
1,571 1,606 
Other Operations
25 1 
Other revenues90 66 
Intercompany eliminations(1,303)(1,101)
Total Fees and other revenues
3,326 3,071 
Total revenues from external customers$56,965 $46,240 
(1)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. Information presented for the three months ended March 31, 2023 has been restated to conform to the new operating segment presentation.
v3.24.1.u1
Description of Business (Details) - Medicare Advantage and related Cigna Healthcare businesses - Held-for-Sale
$ 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
v3.24.1.u1
Summary of Significant Accounting Policies (Details) - USD ($)
$ / shares in Units, $ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
New Accounting Pronouncements or Change in Accounting Principle [Line Items]        
Decrease to shareholders' equity $ (41,350) $ (44,518) $ (46,244) $ (44,688)
Increase to shareholders' net income $ (277) $ 1,267    
Increase to diluted earnings per share (in dollars per share) $ (0.97) $ 4.24    
Pharmacy Benefits Management Services | Guarantees        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]        
Performance guarantee liability $ 1,900   $ 1,600  
v3.24.1.u1
Accounts Receivable, Net - Amounts Included in Accounts Receivable, Net (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Accounts, Notes, Loans and Financing Receivable [Line Items]    
Noninsurance customer receivables, including held for sale assets $ 9,735 $ 8,044
Pharmaceutical manufacturers receivable, including held for sale assets 9,512 8,169
Insurance customer receivables, including held for sale assets 2,045 2,359
Other receivables, including held for sale assets 230 272
Total 21,522 18,844
Accounts receivable, net 20,563 17,722
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 $ (959) $ (1,122)
v3.24.1.u1
Accounts Receivable, Net - Narrative (Details) - USD ($)
$ in Millions
 1 Months Ended 3 Months Ended
Jul. 31, 2023
Mar. 31, 2024
Dec. 31, 2023
Receivables [Abstract]      
Allowance for receivables, current   $ 4,500 $ 3,700
Allowance for current expected credit losses on accounts receivable   91 90
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   1,900  
Accounts receivable sold that remain outstanding, uncommitted factoring facility   93  
Accounts receivable received but not remitted, uncommitted factoring facility   $ 722 $ 515
v3.24.1.u1
Supplier Finance Program (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Payables and Accruals [Abstract]    
Outstanding payment obligations, current $ 1,600 $ 1,500
Outstanding payment obligations, current, voluntarily elected by suppliers to be sold to the financial institution $ 327  
Supplier Finance Program, Obligation, Current, Statement of Financial Position [Extensible Enumeration] Accounts payable Accounts payable
v3.24.1.u1
Assets and Liabilities of Businesses Held for Sale (Details) - Medicare Advantage and related Cigna Healthcare businesses - Held-for-Sale - USD ($)
$ in Millions
Mar. 31, 2024
Jan. 31, 2024
Dec. 31, 2023
Disposal Group, Including Discontinued Operation, Balance Sheet Disclosures [Abstract]      
Cash and cash equivalents $ 1,660   $ 467
Investments 1,341   1,438
Accounts receivable, net 959   1,122
Other assets, including Goodwill 2,394   2,963
Goodwill classified as Assets of businesses held for sale 396   396
Total assets of businesses held for sale 6,354   5,990
Insurance and contractholder liabilities 2,081   1,636
All other liabilities 1,134   1,059
Total liabilities of businesses held for sale $ 3,215   $ 2,695
Health Care Service Corporation (HCSC)      
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Sale price   $ 3,300  
v3.24.1.u1
Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Earnings Per Share [Abstract]    
Shareholders' net income $ (277) $ 1,267
Shares:    
Weighted average (in shares) 286,465 295,706
Common stock equivalents (in shares) 0 3,293
Total shares (in shares) 286,465 298,999
EPS, basic (in dollars per share) $ (0.97) $ 4.28
EPS, effect of dilution (in dollars per share) 0 (0.04)
EPS, diluted (in dollars per share) $ (0.97) $ 4.24
v3.24.1.u1
Earnings Per Share - Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share (Details) - shares
shares in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Antidilutive options (in shares) 8.2  
Employee Stock Options    
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]    
Antidilutive options (in shares)   0.9
v3.24.1.u1
Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares
shares in Millions
Mar. 31, 2024
Dec. 31, 2023
Mar. 31, 2023
Earnings Per Share [Abstract]      
Shares of common stock held in treasury 117.8 107.4 102.7
v3.24.1.u1
Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)
Mar. 31, 2024
Dec. 31, 2023
Jan. 15, 2023
Short-term debt      
Commercial paper $ 884,000,000 $ 1,237,000,000  
Other, including finance leases 42,000,000 42,000,000  
Total short-term debt 1,715,000,000 2,775,000,000  
Long-term debt      
Other, including finance leases 59,000,000 66,000,000  
Total long-term debt 31,053,000,000 28,155,000,000  
$500 million, 0.613% Notes due March 2024      
Short-term debt      
Current maturities 0 500,000,000  
Long-term debt      
Gross value $ 500,000,000    
Interest Rate 0.613%    
$790 million, 3.500% Notes due June 2024      
Short-term debt      
Current maturities $ 789,000,000 996,000,000  
Long-term debt      
Gross value $ 790,000,000    
Interest Rate 3.50%    
$900 million, 3.250% Notes due April 2025 (2)      
Long-term debt      
Long-term debt $ 881,000,000 882,000,000  
Gross value $ 900,000,000    
Interest Rate 3.25%    
$1,216 million, 4.125% Notes due November 2025 (1)      
Long-term debt      
Long-term debt $ 1,214,000,000 2,197,000,000  
Gross value $ 1,216,000,000    
Interest Rate 4.125%    
$1,284 million, 4.500% Notes due February 2026 (1)      
Long-term debt      
Long-term debt $ 1,285,000,000 1,502,000,000  
Gross value $ 1,284,000,000    
Interest Rate 4.50%    
$550 million, 1.250% Notes due March 2026 (1)      
Long-term debt      
Long-term debt $ 549,000,000 798,000,000  
Gross value $ 550,000,000    
Interest Rate 1.25%    
$700 million, 5.685% Notes due March 2026      
Long-term debt      
Long-term debt $ 698,000,000 698,000,000  
Gross value $ 700,000,000    
Interest Rate 5.685%    
$1,500 million, 3.400% Notes due March 2027      
Long-term debt      
Long-term debt $ 1,454,000,000 1,450,000,000  
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      
Long-term debt      
Long-term debt $ 598,000,000 597,000,000  
Gross value $ 600,000,000    
Interest Rate 3.05%    
$3,800 million, 4.375% Notes due October 2028      
Long-term debt      
Long-term debt $ 3,788,000,000 3,787,000,000  
Gross value $ 3,800,000,000    
Interest Rate 4.375%    
$1,000 million, 5.000% Notes due May 2029      
Long-term debt      
Long-term debt $ 994,000,000 0  
Gross value $ 1,000,000,000    
Interest Rate 5.00%    
$1,400 million, 2.400% Notes due March 2030 (1)      
Long-term debt      
Long-term debt $ 1,394,000,000 1,493,000,000  
Gross value $ 1,400,000,000    
Interest Rate 2.40%    
$1,500 million, 2.375% Notes due March 2031 (2)      
Long-term debt      
Long-term debt $ 1,382,000,000 1,397,000,000  
Gross value $ 1,500,000,000    
Interest Rate 2.375%    
$750 million, 5.125% Notes due May 2031      
Long-term debt      
Long-term debt $ 745,000,000 0  
Gross value $ 750,000,000    
Interest Rate 5.125%    
$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 $ 794,000,000 794,000,000  
Gross value $ 800,000,000    
Interest Rate 5.40%    
$1,250 million, 5.250% Notes due February 2034      
Long-term debt      
Long-term debt $ 1,242,000,000 0  
Gross value $ 1,250,000,000    
Interest Rate 5.25%    
$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 2,193,000,000  
Gross value $ 2,200,000,000    
Interest Rate 4.80%    
$750 million, 3.200% Notes due March 2040      
Long-term debt      
Long-term debt $ 744,000,000 744,000,000  
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 $ 487,000,000 487,000,000  
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 1,467,000,000  
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 2,970,000,000  
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 1,237,000,000  
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 1,479,000,000  
Gross value $ 1,500,000,000    
Interest Rate 3.40%    
$1,500 million, 5.600% Notes due February 2054      
Long-term debt      
Long-term debt $ 1,482,000,000 $ 0  
Gross value $ 1,500,000,000    
Interest Rate 5.60%    
v3.24.1.u1
Debt - Short-term and Credit Facilities Debt (Details)
 1 Months Ended 3 Months Ended
Apr. 30, 2024
USD ($)
revolvingCreditFacility
position
Apr. 30, 2023
USD ($)
Mar. 31, 2024
USD ($)
Debt Instrument [Line Items]      
Commercial paper average interest rate     5.54%
Commercial Paper      
Debt Instrument [Line Items]      
Maximum borrowing capacity     $ 5,000,000,000
Revolving Credit Agreements, April 2024 | Subsequent Event      
Debt Instrument [Line Items]      
Maximum borrowing capacity $ 6,500,000,000    
Aggregate amount of options to increase commitments 1,500,000,000    
Maximum total commitment $ 8,000,000,000    
Number of revolving credit facilities | revolvingCreditFacility 2    
Number of participating banks | position 22    
Leverage ratio covenant 60.00%    
Five-year Revolving Credit Agreement, Maturing April 2029 | Subsequent Event      
Debt Instrument [Line Items]      
Maximum borrowing capacity $ 5,000,000,000    
Credit agreement term 5 years    
Credit agreement extension term 1 year    
Five-year Revolving Credit Agreement, Maturing April 2029 | Letter of Credit | Subsequent Event      
Debt Instrument [Line Items]      
Maximum borrowing capacity $ 500,000,000    
364-day Revolving Credit Agreement, Maturing April 2025 | Subsequent Event      
Debt Instrument [Line Items]      
Maximum borrowing capacity $ 1,500,000,000    
Credit agreement term 364 days    
Credit facility, conversion to term loan, term 1 year    
Revolving credit agreements, April 2023      
Debt Instrument [Line Items]      
Outstanding balances     $ 0
Maximum borrowing capacity   $ 5,000,000,000  
Five-year Revolving Credit Agreement, Maturing April 2028      
Debt Instrument [Line Items]      
Maximum borrowing capacity   $ 4,000,000,000  
Credit agreement term   5 years  
364-day Revolving Credit Agreement, Maturing April 2024      
Debt Instrument [Line Items]      
Maximum borrowing capacity   $ 1,000,000,000  
Credit agreement term   364 days  
v3.24.1.u1
Debt - Long-term Debt (Details)
 1 Months Ended 3 Months Ended
Feb. 29, 2024
USD ($)
Mar. 31, 2024
USD ($)
Mar. 31, 2023
USD ($)
Debt Instrument [Line Items]      
Aggregate principal amount of outstanding debt securities redeemed   $ 1,800,000,000  
Repayment of long-term debt   $ 2,210,000,000 $ 80,000,000
Senior Notes      
Debt Instrument [Line Items]      
Principal $ 4,500,000,000    
$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  
$790 million, 3.500% Notes due June 2024      
Debt Instrument [Line Items]      
Interest rate   3.50%  
Gross value   $ 790,000,000  
$1,000 million, 5.000% Notes due May 2029      
Debt Instrument [Line Items]      
Interest rate   5.00%  
Gross value   $ 1,000,000,000  
$1,000 million, 5.000% Notes due May 2029 | Senior Notes      
Debt Instrument [Line Items]      
Principal $ 1,000,000,000    
Interest rate 5.00%    
Net proceeds $ 995,000,000    
$1,000 million, 5.000% Notes due May 2029 | Senior Notes | Treasury rate      
Debt Instrument [Line Items]      
Redemption price discount, spread on variable rate 0.0015    
$750 million, 5.125% Notes due May 2031      
Debt Instrument [Line Items]      
Interest rate   5.125%  
Gross value   $ 750,000,000  
$750 million, 5.125% Notes due May 2031 | Senior Notes      
Debt Instrument [Line Items]      
Principal $ 750,000,000    
Interest rate 5.125%    
Net proceeds $ 746,000,000    
$750 million, 5.125% Notes due May 2031 | Senior Notes | Treasury rate      
Debt Instrument [Line Items]      
Redemption price discount, spread on variable rate 0.0015    
$1,250 million, 5.250% Notes due February 2034      
Debt Instrument [Line Items]      
Interest rate   5.25%  
Gross value   $ 1,250,000,000  
$1,250 million, 5.250% Notes due February 2034 | Senior Notes      
Debt Instrument [Line Items]      
Principal $ 1,250,000,000    
Interest rate 5.25%    
Net proceeds $ 1,244,000,000    
$1,250 million, 5.250% Notes due February 2034 | Senior Notes | Treasury rate      
Debt Instrument [Line Items]      
Redemption price discount, spread on variable rate 0.0020    
$1,500 million, 5.600% Notes due February 2054      
Debt Instrument [Line Items]      
Interest rate   5.60%  
Gross value   $ 1,500,000,000  
$1,500 million, 5.600% Notes due February 2054 | Senior Notes      
Debt Instrument [Line Items]      
Principal $ 1,500,000,000    
Interest rate 5.60%    
Net proceeds $ 1,485,000,000    
$1,500 million, 5.600% Notes due February 2054 | Senior Notes | Treasury rate      
Debt Instrument [Line Items]      
Redemption price discount, spread on variable rate 0.0020    
v3.24.1.u1
Debt - Interest Expense (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Debt Disclosure [Abstract]    
Interest expense on long-term and short-term debt $ 369 $ 345
v3.24.1.u1
Common and Preferred Stock - Dividends (Details) - USD ($)
$ / shares in Units, $ in Millions
 3 Months Ended
Apr. 24, 2024
Mar. 21, 2024
Mar. 23, 2023
Mar. 31, 2024
Mar. 31, 2023
Subsequent Event [Line Items]          
Common dividends declared (in dollars per share)       $ 1.40 $ 1.23
Amount per share (in dollars per share)   $ 1.40 $ 1.23    
Total amount paid   $ 401 $ 368 $ 401 $ 368
Subsequent Event          
Subsequent Event [Line Items]          
Common dividends declared (in dollars per share) $ 1.40        
v3.24.1.u1
Common and Preferred Stock - Accelerated Share Repurchase Agreements (Details) - USD ($)
shares in Millions
 3 Months Ended
Feb. 15, 2024
Jun. 30, 2024
Mar. 31, 2024
Mar. 31, 2023
Accelerated Share Repurchases [Line Items]        
Stock repurchased     $ 4,057,000,000 $ 958,000,000
Treasury Stock        
Accelerated Share Repurchases [Line Items]        
Stock repurchased     3,417,000,000 958,000,000
Additional Paid-in Capital        
Accelerated Share Repurchases [Line Items]        
Stock repurchased     $ 640,000,000 $ 0
Accelerated Share Repurchase Agreement, February 2024        
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      
Accelerated Share Repurchase Agreement, February 2024 | Treasury Stock        
Accelerated Share Repurchases [Line Items]        
Stock repurchased $ 2,600,000,000      
Accelerated Share Repurchase Agreement, February 2024 | Treasury Stock | Forecast        
Accelerated Share Repurchases [Line Items]        
Stock repurchased   $ 640,000,000    
Accelerated Share Repurchase Agreement, February 2024 | Additional Paid-in Capital        
Accelerated Share Repurchases [Line Items]        
Stock repurchased $ 640,000,000      
Accelerated Share Repurchase Agreement, February 2024 | Additional Paid-in Capital | Forecast        
Accelerated Share Repurchases [Line Items]        
Stock repurchased   $ (640,000,000)    
v3.24.1.u1
Insurance and Contractholder Liabilities - Account Balances (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Mar. 31, 2023
Dec. 31, 2022
Current        
Market risk benefits, current $ 26 $ 37    
Unearned premiums, current, including held for sale liabilities 815 846    
Total, current 7,357 6,633    
Current insurance and contractholder liabilities 5,788 5,514    
Non-current        
Market risk benefits, non-current 865 966    
Unearned premiums, non-current, including held for sale liabilities 21 22    
Total, non-current 11,153 11,421    
Non-current insurance and contractholder liabilities 10,641 10,904    
Total        
Market risk benefits 891 1,003 $ 1,220  
Unearned premiums     1,440  
Unearned premiums, including held for sale liabilities 836 868    
Total 18,510 18,054    
Total insurance and contractholder liabilities 16,429 16,418 18,956  
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses        
Current        
Insurance and contractholder liabilities current, classified as held for sale (1,569) (1,119)    
Non-current        
Insurance and contractholder liabilities, non-current, classified as held for sale (512) (517)    
Total        
Insurance and contractholder liabilities classified as held for sale (2,081) (1,636)    
Unpaid claims classified as liabilities of business held for sale 1,378 823    
Future policy benefits classified as liabilities of business held for sale   429    
Unearned premiums classified as liabilities of business held for sale 161 261    
Contractholder deposit funds classified as liabilities held for sale 115 123    
Cigna Healthcare        
Current        
Unpaid claims and claim expenses, current, including held for sale liabilities 5,786 5,017    
Future policy benefits, current, including held for sale liabilities 92 97    
Contractholder deposit funds, current, including held for sale liabilities 11 12    
Non-current        
Unpaid claims and claim expenses, non-current, including held for sale liabilities 77 75    
Future policy benefits, non-current, including held for sale liabilities 515 518    
Contractholder deposit funds, non-current, including liabilities held for sale 130 133    
Total        
Unpaid claims and claim expenses     4,959 $ 4,176
Unpaid claims and claim expenses, including held for sale liabilities 5,863 5,092    
Total liability for future policy benefits     601  
Future policy benefits, including held for sale liabilities 607 615    
Contractholder deposit funds     163  
Contractholder deposit funds, including liabilities held for sale 141 145    
Cigna Healthcare | Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses        
Total        
Future policy benefits classified as liabilities of business held for sale 427      
Other Operations        
Current        
Unpaid claims and claim expenses, current 99 99    
Future policy benefits, current 163 163    
Contractholder deposit funds, current 365 362    
Non-current        
Unpaid claims and claim expenses, non-current 161 154    
Future policy benefits, non-current 3,297 3,375    
Contractholder deposit funds, non-current 6,087 6,178    
Total        
Unpaid claims and claim expenses 260 253 272  
Total liability for future policy benefits 3,460 3,538 3,631  
Contractholder deposit funds $ 6,452 $ 6,540 $ 6,670 $ 6,700
v3.24.1.u1
Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Cigna Healthcare - Activity (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2023
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses      
Paid costs related to:      
Unpaid claims classified as liabilities of business held for sale $ 1,378   $ 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 5,400 $ 4,600  
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]      
Beginning balance   4,176  
Less: Reinsurance and other amounts recoverable   221  
Beginning balance, net   3,955  
Beginning balance, including held for sale liabilities 5,092    
Less: Reinsurance, including held for sale liabilities 236    
Beginning balance, net, including held for sale liabilities 4,856    
Incurred costs related to:      
Current year 9,452 9,041  
Prior years (226) (144)  
Total incurred 9,226 8,897  
Paid costs related to:      
Current year 5,072 5,316  
Prior years 3,352 2,795  
Total paid 8,424 8,111  
Ending balance, net   4,741  
Add: Reinsurance and other amounts recoverable   218  
Ending balance   $ 4,959  
Ending balance, net, including held for sale liabilities 5,658    
Add: Reinsurance, including held for sale liabilities 205    
Ending balance, including held for sale liabilities $ 5,863    
v3.24.1.u1
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
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]    
Favorable (unfavorable) variance, amount $ 226 $ 144
Favorable (unfavorable) variance, percentage 0.60% 0.50%
Actual completion factors    
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]    
Favorable (unfavorable) variance, amount $ 76 $ 1
Favorable (unfavorable) variance, percentage 0.20% 0.00%
Medical cost trend    
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]    
Favorable (unfavorable) variance, amount $ 150 $ 143
Favorable (unfavorable) variance, percentage 0.40% 0.50%
v3.24.1.u1
Insurance and Contractholder Liabilities - Future Policy Benefits - Interest Rates and Duration (Details)
Mar. 31, 2024
Mar. 31, 2023
Cigna Healthcare    
Insurance and Contractholder Liabilities [Line Items]    
Interest accretion rate 2.56% 2.59%
Current discount rate 5.11% 5.29%
Weighted average duration 7 years 9 months 18 days 8 years 1 month 6 days
Other Operations    
Insurance and Contractholder Liabilities [Line Items]    
Interest accretion rate 5.64% 5.64%
Current discount rate 5.16% 4.95%
Weighted average duration 11 years 3 months 18 days 11 years 8 months 12 days
v3.24.1.u1
Insurance and Contractholder Liabilities - Future Policy Benefits - Present Value of Expected Premiums and Benefits (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2023
Dec. 31, 2022
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 $ 9,233 $ 8,557    
Reversal of effect of beginning of period discount rate assumptions 1,154 1,537    
Issuances and lapses 446 306    
Net premiums collected (350) (326)    
Interest and other 73 56    
Ending balance at original discount rate 10,556 10,130    
Effect of end of period discount rate assumptions (1,309) (1,312)    
Ending balance 9,247 8,818 9,233 $ 8,557
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]        
Beginning balance 9,633 8,945    
Reversal of effect of discount rate assumptions 1,220 1,611    
Issuances and lapses 457 307    
Benefit payments (362) (326)    
Interest and other 71 58    
Ending balance at original discount rate 11,019 10,595    
Effect of discount rate assumptions (1,381) (1,378)    
Ending balance 9,638 9,217 9,633 8,945
Liability for future policy benefits 391 399    
Other 216 202    
Total liability for future policy benefits   601    
Total liability for future policy benefits, including assets held for sale 607      
Undiscounted expected future gross premiums 19,000 17,600    
Discounted expected future gross premiums 13,300 12,500    
Undiscounted expected future policy benefits 13,600 12,800    
Future policy benefits reserve, reinsurance recoverables 72 154    
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 81      
Future policy benefits classified as liabilities of business held for sale 427      
Other Operations        
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]        
Total liability for future policy benefits 3,460 3,631 3,538  
Undiscounted expected future policy benefits 4,400 4,600    
Future policy benefits reserve, reinsurance recoverables 1,000 1,000    
Future policy benefits, DPL 379 392    
Future policy benefit, excluding DPL $ 3,100 $ 3,200 $ 3,200 $ 3,200
v3.24.1.u1
Insurance and Contractholder Liabilities - Contractholder Deposit Funds (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Mar. 31, 2023
Dec. 31, 2022
Insurance and Contractholder Liabilities [Line Items]        
Contractholder deposit fund liabilities, approximate percent reinsured externally 38.00%      
Cigna Healthcare        
Insurance and Contractholder Liabilities [Line Items]        
Contractholder deposit funds     $ 163  
Other Operations        
Insurance and Contractholder Liabilities [Line Items]        
Contractholder deposit funds $ 6,452 $ 6,540 $ 6,670 $ 6,700
Weighted average crediting rate 3.33%   3.25%  
Net amount at risk $ 3,000   $ 3,200  
Cash surrender value $ 2,800   $ 2,800  
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%  
v3.24.1.u1
Insurance and Contractholder Liabilities - Summary of Market Risk Benefit (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Insurance Loss Reserves [Abstract]    
Annuitization election period 30 days  
Market Risk Benefit [Roll Forward]    
Balance, beginning of year $ 1,003 $ 1,268
Balance, beginning of year, before the effect of nonperformance risk (own credit risk) 1,085 1,379
Changes due to expected run-off (3) (6)
Changes due to capital markets versus expected (113) (41)
Changes due to policyholder behavior versus expected (14) 6
Assumption changes 0 (33)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk) 955 1,305
Nonperformance risk (own credit risk), end of period (64) (85)
Balance, end of period 891 1,220
Reinsured market risk benefit, end of period $ 951 $ 1,301
v3.24.1.u1
Insurance and Contractholder Liabilities - Net Amount of Risk and Average Age of Contractholders (Details) - Variable Annuity - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Net Amount at Risk by Product and Guarantee [Line Items]    
Net amount at risk $ 1,441 $ 2,183
Average attained age of contractholders (weighted by exposure) 77 years 8 months 12 days 75 years 4 months 24 days
v3.24.1.u1
Reinsurance - Reinsurance Recoverables (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Mar. 31, 2023
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale $ 4,131  
Allowance for uncollectible reinsurance, including assets held for sale (35)  
Market risk benefits 951 $ 1,301
Total reinsurance recoverables, including assets held for sale 5,047  
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 209  
Other Current Assets    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables 166  
Berkshire Hathway Life Insurance Company Of Nebraska and Other Recoverables    
Ceded Credit Risk [Line Items]    
Market risk benefits 951  
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 663  
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 2,989  
No collateral    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 479  
Ongoing Operations    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 485  
Ongoing Operations | A- equivalent and higher current ratings    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 85  
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 60  
Ongoing Operations | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 340  
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 145  
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 145  
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 7  
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 7  
Ongoing Operations | No collateral    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 333  
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 85  
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 60  
Ongoing Operations | No collateral | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 188  
Acquisition, disposition or run-off activities    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 3,646  
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 2,619  
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 128  
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 351  
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 334  
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 204  
Acquisition, disposition or run-off activities | Not rated    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 10  
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 518  
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 351  
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 167  
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 2,982  
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 2,619  
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 334  
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 23  
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 6  
Acquisition, disposition or run-off activities | No collateral    
Ceded Credit Risk [Line Items]    
Reinsurance recoverables before market risk benefits, including assets held for sale 146  
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 128  
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  
v3.24.1.u1
Reinsurance - Effective Exit of Variable Annuity Reinsurance Business (Details) - Variable Annuity - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2023
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 974   $ 1,100
Incurred but not yet paid and outstanding claims 23   19
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 $ 777   873
Berkshire | 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%    
Sun Life Assurance Company of Canada      
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 79   92
Liberty Re (Bermuda) Ltd.      
Ceded Credit Risk [Line Items]      
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due $ 91   104
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 $ 27   $ 31
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 75.00%    
v3.24.1.u1
Investments - Investments by Category (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Current    
Investments including held for sale assets $ 1,193 $ 1,009
Current investments 1,108 925
Long-term    
Investments including held for sale assets 17,281 19,339
Investments per Consolidated Balance Sheets 16,025 17,985
Total    
Investments including held for sale assets 18,474 20,348
Total investments 17,133 18,910
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses    
Current    
Investments classified as assets of business held for sale (85) (84)
Long-term    
Investments classified as assets of business held for sale (1,256) (1,354)
Total    
Investments classified as assets of business held for sale (1,341) (1,438)
Debt securities    
Current    
Investments including held for sale assets 604 590
Long-term    
Investments including held for sale assets 8,876 9,265
Total    
Investments including held for sale assets 9,480 9,855
Equity securities    
Current    
Investments including held for sale assets 18 31
Long-term    
Investments including held for sale assets 1,553 3,331
Total    
Investments including held for sale assets 1,571 3,362
Commercial mortgage loans    
Current    
Investments including held for sale assets 197 182
Long-term    
Investments including held for sale assets 1,365 1,351
Total    
Investments including held for sale assets 1,562 1,533
Policy loans    
Current    
Investments including held for sale assets 0 0
Long-term    
Investments including held for sale assets 1,186 1,211
Total    
Investments including held for sale assets 1,186 1,211
Other long-term investments    
Current    
Investments including held for sale assets 0 0
Long-term    
Investments including held for sale assets 4,301 4,181
Total    
Investments including held for sale assets 4,301 4,181
Short-term investments    
Current    
Investments including held for sale assets 374 206
Long-term    
Investments including held for sale assets 0 0
Total    
Investments including held for sale assets $ 374 $ 206
v3.24.1.u1
Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Amortized Cost    
Due in one year or less, including assets held for sale $ 633  
Due after one year through five years, including assets held for sale 3,768  
Due after five years through ten years, including assets held for sale 3,144  
Due after ten years, including assets held for sale 2,186  
Mortgage and other asset-backed securities, including assets held for sale 389  
Total, including assets held for sale 10,120 $ 10,379
Fair Value    
Due in one year or less, including assets held for sale 619  
Due after one year through five years, including assets held for sale 3,587  
Due after five years through ten years, including assets held for sale 2,921  
Due after ten years, including assets held for sale 2,000  
Mortgage and other asset-backed securities, including assets held for sale 353  
Total, including assets held for sale $ 9,480 $ 9,855
v3.24.1.u1
Investments - Narrative (Details) - USD ($)
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2023
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 1,532   $ 3,311
Realized investment losses, net 1,836 $ 56  
VillageMD      
Schedule of Investments [Line Items]      
Equity securities with no readily determinable fair value 900    
Realized investment losses, net $ 1,800    
v3.24.1.u1
Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets $ 10,120 $ 10,379
Allowance for Credit Loss, including held for sale assets (50) (33)
Unrealized Appreciation, including held for sale assets 153 195
Unrealized Depreciation, including held for sale assets (743) (686)
Fair Value, including held for sale assets 9,480 9,855
Federal government and agency    
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets 289 251
Allowance for Credit Loss, including held for sale assets 0 0
Unrealized Appreciation, including held for sale assets 21 24
Unrealized Depreciation, including held for sale assets (10) (8)
Fair Value, including held for sale assets 300 267
State and local government    
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets 37 37
Allowance for Credit Loss, including held for sale assets 0 0
Unrealized Appreciation, including held for sale assets 2 2
Unrealized Depreciation, including held for sale assets (1) (1)
Fair Value, including held for sale assets 38 38
Foreign government    
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets 354 355
Allowance for Credit Loss, including held for sale assets 0 0
Unrealized Appreciation, including held for sale assets 8 10
Unrealized Depreciation, including held for sale assets (14) (13)
Fair Value, including held for sale assets 348 352
Corporate    
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets 9,051 9,338
Allowance for Credit Loss, including held for sale assets (50) (33)
Unrealized Appreciation, including held for sale assets 122 158
Unrealized Depreciation, including held for sale assets (682) (630)
Fair Value, including held for sale assets 8,441 8,833
Mortgage and other asset-backed    
Debt Securities, Available-for-sale [Line Items]    
Amortized cost, including held for sale assets 389 398
Allowance for Credit Loss, including held for sale assets 0 0
Unrealized Appreciation, including held for sale assets 0 1
Unrealized Depreciation, including held for sale assets (36) (34)
Fair Value, including held for sale assets $ 353 $ 365
v3.24.1.u1
Investments - Debt Securities with a Decline in Fair Value (Details)
$ in Millions
Mar. 31, 2024
USD ($)
position
Dec. 31, 2023
USD ($)
position
Total    
Total Fair Value, including held for sale assets $ 6,577 $ 6,633
Total Amortized Cost, including held for sale assets 7,320 7,319
Total Unrealized Depreciation, including held for sale assets $ (743) $ (686)
Total Number of Issues, including held for sale assets | position 2,413 2,353
Investment grade | Debt securities    
One year or less    
Fair Value, including held for sale assets $ 562 $ 330
Amortized Cost, including held for sale assets 576 338
Unrealized Depreciation, including held for sale assets $ (14) $ (8)
Number of Issues, including held for sale assets | position 232 142
More than one year    
Fair Value, including held for sale assets $ 5,284 $ 5,441
Amortized Cost, including held for sale assets 5,946 6,036
Unrealized Depreciation, including held for sale assets $ (662) $ (595)
Number of Issues, including held for sale assets | position 1,561 1,590
Below investment grade | Debt securities    
One year or less    
Fair Value, including held for sale assets $ 133 $ 161
Amortized Cost, including held for sale assets 137 170
Unrealized Depreciation, including held for sale assets $ (4) $ (9)
Number of Issues, including held for sale assets | position 253 135
More than one year    
Fair Value, including held for sale assets $ 598 $ 701
Amortized Cost, including held for sale assets 661 775
Unrealized Depreciation, including held for sale assets $ (63) $ (74)
Number of Issues, including held for sale assets | position 367 486
v3.24.1.u1
Investments - Equity Security Investments (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Dec. 31, 2023
Cost    
Equity securities with readily determinable fair values $ 647 $ 656
Equity securities with no readily determinable fair value 3,281 3,248
Total 3,928 3,904
Carrying Value    
Equity securities with readily determinable fair values 39 51
Equity securities with no readily determinable fair value 1,532 3,311
Total $ 1,571 $ 3,362
Equity Securities FV NI | Product Concentration Risk | Health Care Sector    
Other Commitments [Line Items]    
Concentration percentage 90.00%  
v3.24.1.u1
Investments - Commercial Mortgage Loan Portfolio (Details) - Real Estate Loan - Commercial Portfolio Segment
$ in Millions
 3 Months Ended 12 Months Ended
Mar. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss, including assets held for sale $ 1,562 $ 1,533
Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio, including assets held for sale 1.81 1.82
Average Loan-to-Value Ratio, including assets held for sale 0.64 0.64
Below 60%    
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss, including assets held for sale $ 810 $ 802
Below 60% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio, including assets held for sale 2.12 2.13
60% to 79%    
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss, including assets held for sale $ 594 $ 574
60% to 79% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio, including assets held for sale 1.75 1.77
80% to 100%    
Schedule of Investments [Line Items]    
Carrying value, after allowance for credit loss, including assets held for sale $ 158 $ 157
80% to 100% | Weighted Average    
Schedule of Investments [Line Items]    
Average Debt Service Coverage Ratio, including assets held for sale 0.63 0.65
v3.24.1.u1
Investments - Other Long-Term Investments (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Schedule of Investments [Line Items]    
Other long term investments, including held for sale assets $ 4,301 $ 4,181
Real estate investments    
Schedule of Investments [Line Items]    
Other long-term investments 1,696 1,606
Securities partnerships    
Schedule of Investments [Line Items]    
Other long-term investments 2,423 2,400
Other    
Schedule of Investments [Line Items]    
Other long term investments, including held for sale assets $ 182 $ 175
v3.24.1.u1
Investments - Realized Gains and Losses on Investments (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Investments [Abstract]    
Net realized investment losses, before income taxes $ (1,836) $ (56)
v3.24.1.u1
Fair Value Measurements - Financial Assets and Liabilities Carried at Fair Value (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Financial assets at fair value:    
Equity securities $ 39 $ 51
Recurring    
Financial assets at fair value:    
Equity securities 39 51
Short-term investments 374 206
Debt Securities, including held for sale assets 9,480 9,855
Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 147 132
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 4 4
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Equity securities 2 4
Short-term investments 0 0
Debt Securities, including held for sale assets 165 130
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:    
Equity securities 37 47
Short-term investments 374 206
Debt Securities, including held for sale assets 8,893 9,278
Significant Other Observable Inputs (Level 2) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 147 131
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 4 4
Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Equity securities 0 0
Short-term investments 0 0
Debt Securities, including held for sale assets 422 447
Significant Unobservable Inputs (Level 3) | Recurring | Forwards, swaps, options    
Financial assets at fair value:    
Derivative assets 0 1
Liabilities, Fair Value Disclosure [Abstract]    
Derivative liabilities 0 0
Federal government and agency | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 300 267
Federal government and agency | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 165 130
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 135 137
Federal government and agency | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
State and local government | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 38 38
State and local government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
State and local government | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 38 38
State and local government | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
Foreign government | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 348 352
Foreign government | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
Foreign government | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 348 352
Foreign government | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
Corporate | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 8,441 8,833
Corporate | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
Corporate | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 8,072 8,432
Corporate | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 369 401
Mortgage and other asset-backed | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 353 365
Mortgage and other asset-backed | Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 0 0
Mortgage and other asset-backed | Significant Other Observable Inputs (Level 2) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets 300 319
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring    
Financial assets at fair value:    
Debt Securities, including held for sale assets $ 53 $ 46
v3.24.1.u1
Fair Value Measurements - Narrative (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Dec. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]      
Equity securities with no readily determinable fair value $ 1,532   $ 3,311
Realized investment losses, net 1,836 $ 56  
VillageMD      
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]      
Equity securities with no readily determinable fair value 900    
Realized investment losses, net 1,800    
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    
v3.24.1.u1
Fair Value Measurements - Quantitative Information About Unobservable Inputs (Details) - Recurring - Significant Unobservable Inputs (Level 3)
$ in Millions
Mar. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Debt securities    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value, including held for sale assets $ 422 $ 447
Corporate | Securities Priced by the Company    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value, including held for sale assets $ 369 $ 401
Corporate | Securities Priced by the Company | Minimum | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment, including held for sale assets 0.0055 0.0070
Corporate | Securities Priced by the Company | Maximum | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment, including held for sale assets 0.1230 0.1235
Corporate | Securities Priced by the Company | Weighted Average | Liquidity    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Unobservable Adjustment, including held for sale assets 0.0280 0.0310
Mortgage and other asset-backed securities | Securities Priced by the Company    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Fair Value, including held for sale assets $ 53 $ 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, including held for sale assets 0.0110 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, including held for sale assets 0.0605 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, including held for sale assets 0.0280 0.0310
v3.24.1.u1
Fair Value Measurements - Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
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 $ (4) $ 5
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 447  
(Losses) gains included in Shareholders' net (loss) income (21) 1
(Losses) gains included in Other comprehensive loss (3) 5
Purchases, sales and settlements    
Purchases 0 4
Settlements (14) (9)
Total purchases, sales and settlements (14) (5)
Transfers into/(out of) Level 3    
Transfers into Level 3 16 39
Transfers out of Level 3 (3) (16)
Total transfers into/(out of) Level 3 13 23
Ending balance   471
Ending balance, including held for sale assets 422  
Total (losses) gains included in Shareholders' net (loss) income attributable to instruments held at the reporting date $ (21) $ 1
v3.24.1.u1
Fair Value Measurements - Fair Values of Separate Account Assets (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts $ 569 $ 578
Non-guaranteed separate accounts 6,181 6,172
Subtotal 6,750 6,750
Non-guaranteed separate accounts priced at NAV as a practical expedient 666 680
Separate account assets 7,416 7,430
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 230 226
Non-guaranteed separate accounts 158 158
Subtotal 388 384
Significant Other Observable Inputs (Level 2)    
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]    
Guaranteed separate accounts 339 352
Non-guaranteed separate accounts 5,794 5,797
Subtotal 6,133 6,149
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 229 217
Subtotal 229 217
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
v3.24.1.u1
Fair Value Measurements - Additional Information on Separate Account Assets Priced at Net Asset Value (Details) - Separate Account Assets - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Dec. 31, 2023
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments $ 252  
Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value 666 $ 680
Securities partnerships    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Unfunded Commitments 252  
Securities partnerships | Recurring | NAV    
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]    
Fair Value 412 419
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 $ 251 258
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 $ 3
v3.24.1.u1
Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($)
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Realized investment losses on assets measured at fair value under certain conditions, after-tax  
Realized investment gains on equity securities with no readily determinable fair value
v3.24.1.u1
Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($)
$ in Millions
Mar. 31, 2024
Dec. 31, 2023
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 $ 29,806 $ 28,033
Fair Value | Significant Unobservable Inputs (Level 3)    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Commercial mortgage loans, including assets held for sale 1,451 1,430
Carrying Value    
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]    
Long-term debt, including current maturities, excluding finance leases 31,783 29,585
Commercial mortgage loans, including assets held for sale $ 1,562 $ 1,533
v3.24.1.u1
Variable Interest Entities (Details) - entity
Mar. 31, 2024
Dec. 31, 2023
Variable Interest Entity, Primary Beneficiary    
Variable Interest Entity [Line Items]    
Number of VIEs 0 0
v3.24.1.u1
Accumulated Other Comprehensive Income (Loss) (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Balance $ 46,244 $ 44,688
Other comprehensive loss, net of tax (460) (111)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests 0 0
Shareholders other comprehensive income (loss), net of tax (460) (111)
Balance 41,350 44,518
Accumulated Other Comprehensive (Loss)    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Balance (1,864) (1,658)
Shareholders other comprehensive income (loss), net of tax (460) (111)
Balance (2,324) (1,769)
Securities and Derivatives    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Balance 171 (332)
Other comprehensive income (loss) before reclassifications, before tax 143 252
Other comprehensive income (loss), before reclassifications, tax (39) (54)
Other comprehensive income (loss) before reclassifications, after-tax 104 198
Reclassification adjustment, tax (5) 1
Net amounts reclassified from AOCI to net income 17 (4)
Shareholders other comprehensive income (loss), net of tax 121 194
Balance 292 (138)
Reclassification adjustment for losses (gains) included in Shareholders' net (loss) income (Net realized investment losses)    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Reclassification adjustment, before tax 22 (5)
Net long-duration insurance and contractholder liabilities measurement adjustments    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Balance (971) (256)
Shareholders other comprehensive income (loss), net of tax (560) (331)
Balance (1,531) (587)
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 (732) (411)
Other comprehensive income (loss), before reclassifications, tax 186 101
Other comprehensive income (loss) before reclassifications, after-tax (546) (310)
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 (18) (26)
Other comprehensive income (loss), before reclassifications, tax 4 5
Other comprehensive income (loss) before reclassifications, after-tax (14) (21)
Translation of foreign currencies including portion attributable to noncontrolling interest    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Translation of foreign currencies, before tax (24) 15
Other Comprehensive Income (Loss), Tax, Including Temporary Equity (2) 1
Other comprehensive loss, net of tax (26) 16
Translation of foreign currencies attributable to parent    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Balance (149) (154)
Balance (175) (138)
Postretirement benefits liability    
Accumulated Other Comprehensive Income (Loss) [Line Items]    
Balance (915) (916)
Reclassification adjustment, tax (3) (3)
Shareholders other comprehensive income (loss), net of tax 5 10
Balance (910) (906)
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 $ 8 $ 13
v3.24.1.u1
Income Taxes - Narrative (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Income Tax Disclosure [Abstract]    
Consolidated effective tax rate 368.40% 18.40%
Deferred tax assets associated with unrealized investment losses $ 664  
Valuation allowance of deferred tax assets associated with unrealized investment losses $ 427  
v3.24.1.u1
Contingencies and Other Matters (Details)
 1 Months Ended 3 Months Ended
Mar. 31, 2022
USD ($)
Apr. 19, 2016
claim
Mar. 31, 2016
USD ($)
Mar. 31, 2024
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       410,000,000
Assets maintained by employers (minimum)       410,000,000
Liability for guarantees       $ 0
v3.24.1.u1
Segment Information - Summary of Special Items (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Pre-tax    
Integration and transaction-related costs, pre-tax $ 37 $ 1
(Gain) loss on sale of business 19 0
Deferred tax (benefits), net (Income taxes, less amount attributable to noncontrolling interests) 0 0
Total impact from special items 56 1
After-tax    
Integration and transaction-related costs, after-tax (Selling, general and administrative expenses) 29 1
(Gain) loss on sale of business, after-tax (43) 0
Deferred tax (benefits), net, after-tax (Income taxes, less amount attributable to noncontrolling interests) 17 0
Total impact from special items $ 3 $ 1
v3.24.1.u1
Segment Information - Summarized Segment Financial Information (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Segment Reporting Information [Line Items]    
Revenues from customers $ 56,965 $ 46,240
Net investment income (loss) 290 277
TOTAL REVENUES 57,255 46,517
Net realized investment results from certain equity method investments (8) (38)
Adjusted revenues 57,247 46,479
Depreciation and amortization 741 749
Income before income taxes 79 1,601
Pre-tax adjustments to reconcile to adjusted income from operations    
(Income) loss attributable to noncontrolling interests (77) (43)
Net realized investment (gains) losses 1,828 18
Amortization of acquired intangible assets 423 459
Special items    
Integration and transaction-related costs 37 1
(Gain) loss on sale of business 19 0
Pre-tax adjusted income (loss) from operations 2,309 2,036
Evernorth Health Services    
Segment Reporting Information [Line Items]    
Revenues from customers 44,886 34,511
Cigna Healthcare    
Segment Reporting Information [Line Items]    
Revenues from customers 12,012 11,650
Other Operations    
Segment Reporting Information [Line Items]    
Revenues from customers 66 79
Operating Segments | Evernorth Health Services    
Segment Reporting Information [Line Items]    
Net investment income (loss) 59 50
TOTAL REVENUES 46,226 36,179
Net realized investment results from certain equity method investments 0 0
Adjusted revenues 46,226 36,179
Income before income taxes (436) 918
Pre-tax adjustments to reconcile to adjusted income from operations    
(Income) loss attributable to noncontrolling interests (77) (42)
Net realized investment (gains) losses 1,456 0
Amortization of acquired intangible assets 417 444
Special items    
Integration and transaction-related costs 0 0
(Gain) loss on sale of business 0  
Pre-tax adjusted income (loss) from operations 1,360 1,320
Operating Segments | Cigna Healthcare    
Segment Reporting Information [Line Items]    
Net investment income (loss) 149 143
TOTAL REVENUES 13,285 12,756
Net realized investment results from certain equity method investments (8) (38)
Adjusted revenues 13,277 12,718
Income before income taxes 943 1,077
Pre-tax adjustments to reconcile to adjusted income from operations    
(Income) loss attributable to noncontrolling interests 0 (1)
Net realized investment (gains) losses 372 24
Amortization of acquired intangible assets 6 15
Special items    
Integration and transaction-related costs 0 0
(Gain) loss on sale of business 19  
Pre-tax adjusted income (loss) from operations 1,340 1,115
Operating Segments | Other Operations    
Segment Reporting Information [Line Items]    
Net investment income (loss) 75 78
TOTAL REVENUES 166 157
Net realized investment results from certain equity method investments 0 0
Adjusted revenues 166 157
Income before income taxes 18 21
Pre-tax adjustments to reconcile to adjusted income from operations    
(Income) loss attributable to noncontrolling interests 0 0
Net realized investment (gains) losses 0 (6)
Amortization of acquired intangible assets 0 0
Special items    
Integration and transaction-related costs 0 0
(Gain) loss on sale of business 0  
Pre-tax adjusted income (loss) from operations 18 15
Corporate and Eliminations    
Segment Reporting Information [Line Items]    
Net investment income (loss) 7 6
TOTAL REVENUES (2,422) (2,575)
Net realized investment results from certain equity method investments 0 0
Adjusted revenues (2,422) (2,575)
Income before income taxes (446) (415)
Special items    
Pre-tax adjusted income (loss) from operations (409) (414)
Corporate    
Segment Reporting Information [Line Items]    
Revenues from customers 1 0
Pre-tax adjustments to reconcile to adjusted income from operations    
(Income) loss attributable to noncontrolling interests 0 0
Net realized investment (gains) losses 0 0
Amortization of acquired intangible assets 0 0
Special items    
Integration and transaction-related costs 37 1
(Gain) loss on sale of business 0  
Intersegment Eliminations    
Segment Reporting Information [Line Items]    
Revenues from customers (2,430) (2,581)
Intersegment Eliminations | Evernorth Health Services    
Segment Reporting Information [Line Items]    
Revenues from customers (1,281) (1,618)
Intersegment Eliminations | Cigna Healthcare    
Segment Reporting Information [Line Items]    
Revenues from customers (1,124) (963)
Intersegment Eliminations | Other Operations    
Segment Reporting Information [Line Items]    
Revenues from customers $ (25) $ 0
v3.24.1.u1
Segment Information - Revenue from External Customers (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Revenue from External Customer [Line Items]    
Premiums $ 11,603 $ 11,025
Total revenues from external customers 56,965 46,240
Pharmacy revenues    
Revenue from External Customer [Line Items]    
Revenues 42,036 32,144
Service    
Revenue from External Customer [Line Items]    
Revenues 3,326 3,071
Evernorth Health Services    
Revenue from External Customer [Line Items]    
Total revenues from external customers 44,886 34,511
Cigna Healthcare    
Revenue from External Customer [Line Items]    
Total revenues from external customers 12,012 11,650
Other Operations    
Revenue from External Customer [Line Items]    
Total revenues from external customers 66 79
Intersegment Eliminations    
Revenue from External Customer [Line Items]    
Premiums 24 16
Total revenues from external customers (2,430) (2,581)
Intersegment Eliminations | Pharmacy revenues    
Revenue from External Customer [Line Items]    
Revenues (1,151) (1,496)
Intersegment Eliminations | Service    
Revenue from External Customer [Line Items]    
Revenues (1,303) (1,101)
Intersegment Eliminations | Evernorth Health Services    
Revenue from External Customer [Line Items]    
Total revenues from external customers (1,281) (1,618)
Intersegment Eliminations | Cigna Healthcare    
Revenue from External Customer [Line Items]    
Total revenues from external customers (1,124) (963)
Intersegment Eliminations | Other Operations    
Revenue from External Customer [Line Items]    
Total revenues from external customers (25) 0
Operating Segments | Other revenues    
Revenue from External Customer [Line Items]    
Revenues 90 66
Operating Segments | Evernorth Health Services | Pharmacy revenues    
Revenue from External Customer [Line Items]    
Revenues 43,170 33,640
Operating Segments | Evernorth Health Services | Network revenues    
Revenue from External Customer [Line Items]    
Revenues 24,166 15,748
Operating Segments | Evernorth Health Services | Home delivery and specialty revenues    
Revenue from External Customer [Line Items]    
Revenues 16,458 16,025
Operating Segments | Evernorth Health Services | Other revenues    
Revenue from External Customer [Line Items]    
Revenues 2,546 1,867
Operating Segments | Evernorth Health Services | Fees    
Revenue from External Customer [Line Items]    
Revenues 2,943 2,499
Operating Segments | Cigna Healthcare    
Revenue from External Customer [Line Items]    
Premiums 11,531 10,930
Operating Segments | Cigna Healthcare | Fees    
Revenue from External Customer [Line Items]    
Revenues 1,571 1,606
Operating Segments | Cigna Healthcare | U.S. Healthcare    
Revenue from External Customer [Line Items]    
Premiums 10,646 10,144
Operating Segments | Cigna Healthcare | U.S. Healthcare | Employer insured    
Revenue from External Customer [Line Items]    
Premiums 4,393 4,080
Operating Segments | Cigna Healthcare | U.S. Healthcare | Medicare Advantage    
Revenue from External Customer [Line Items]    
Premiums 2,287 2,236
Operating Segments | Cigna Healthcare | U.S. Healthcare | Stop loss    
Revenue from External Customer [Line Items]    
Premiums 1,668 1,503
Operating Segments | Cigna Healthcare | U.S. Healthcare | Individual and Family Plans    
Revenue from External Customer [Line Items]    
Premiums 1,040 1,208
Operating Segments | Cigna Healthcare | U.S. Healthcare | Other    
Revenue from External Customer [Line Items]    
Premiums 1,258 1,117
Operating Segments | Cigna Healthcare | International Health    
Revenue from External Customer [Line Items]    
Premiums 885 786
Operating Segments | Other Operations    
Revenue from External Customer [Line Items]    
Premiums 48 79
Operating Segments | Other Operations | Pharmacy revenues    
Revenue from External Customer [Line Items]    
Revenues 17 0
Operating Segments | Other Operations | Fees    
Revenue from External Customer [Line Items]    
Revenues $ 25 $ 1
v3.24.1.u1
Segment Information - Financial and Performance Guarantees (Details) - USD ($)
$ in Billions
Mar. 31, 2024
Dec. 31, 2023
Pharmacy Benefits Management Services | Guarantees    
Loss Contingencies [Line Items]    
Guarantee liability $ 1.9 $ 1.6
v3.24.1.u1
Segment Information - Major Customers (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Loss Contingencies [Line Items]    
Revenues from external customers $ 56,965 $ 46,240
Revenue | Customer Concentration Risk | U.S. Federal Government Agencies    
Loss Contingencies [Line Items]    
Concentration percentage 13.00%  
Revenue | Customer Concentration Risk | Single Pharmacy Benefit Client    
Loss Contingencies [Line Items]    
Concentration percentage 15.00%