Global health services company Cigna Corporation (NYSE: CI) today reported strong third quarter 2022 results reflecting growth in both Evernorth and Cigna Healthcare
Total revenues in the third quarter were $45.3 billion
Shareholders' net income for the third quarter was $2.8 billion, or $8.97 per share
Adjusted income from operations1 for the third quarter was $1.9 billion, or $6.04 per share
Adjusted income from operations1,2 for 2022 is now projected to be at least $23.10 per share2
BLOOMFIELD, Conn., Nov. 3, 2022 /PRNewswire/ -- Global health services company Cigna Corporation (NYSE: CI) today reported strong third quarter 2022 results reflecting growth in both Evernorth and Cigna Healthcare.
"We built on our momentum from the first half of 2022 with strong execution in the third quarter across our businesses and a continued focus on serving customers and clients with our differentiated health and well-being solutions," said David M. Cordani, chairman and chief executive officer. "We're leveraging capabilities across Evernorth and Cigna Healthcare as we innovate to further improve affordability, guide patients to the most effective treatments and improve the vitality of the customers we serve."
Total revenues for third quarter 2022 were $45.3 billion. Adjusted revenues3 were $45.4 billion and reflect strong performance led by Evernorth.
Shareholders' net income for third quarter 2022 was $2.8 billion, or $8.97 per share, including an after-tax special item gain of $1.4 billion, or $4.52 per share, from the Chubb transaction4, and compares with $1.6 billion, or $4.80 per share, for third quarter 2021.
Cigna's adjusted income from operations1 for third quarter 2022 was $1.9 billion, or $6.04 per share, compared with $1.9 billion, or $5.73 per share, for third quarter 2021, reflecting growth in Evernorth and Cigna Healthcare offsetting the absence of income from divested businesses4,5. The proceeds from the Chubb transaction4 were primarily used for share repurchase in 2022.
Reconciliations of total revenues to adjusted revenues3 and of shareholders' net income to adjusted income from operations1 are provided on the following page and on Exhibit 1 of this earnings release.
The following table includes highlights of results and reconciliations of total revenues to adjusted revenues3 and shareholders' net income to adjusted income from operatio
Consolidated Financial Results (dollars in millions):
Net Realized Investment Losses (Gains) from Equity Method Investments3
Consolidated Earnings, net of taxes
Net Realized Investment Losses (Gains)1
Amortization of Acquired Intangible Assets1
Adjusted Income from Operations1
Shareholders' Net Income, per share
Adjusted Income from Operations1, per share
Adjusted income from operations1 for the third quarter 2022 increased 3% from third quarter 2021, excluding the divested international life, accident and supplement benefits4 and Medicaid5 businesses6, with contributions from both Evernorth and Cigna Healthcare.
The adjusted SG&A expense ratio7 was 6.9% for third quarter 2022 compared to 7.0% for third quarter 2021 reflecting revenue growth partially offset by strategic investments.
The debt-to-capitalization ratio decreased to 41.2% at September 30, 2022 from 41.7% at December 31, 2021.
Year to date through November 3, 2022, the Company will have repurchased 22.0 million shares of common stock for approximately $5.8 billion including the final settlement of the accelerated share repurchase agreements announced in June.
The following table summarizes Cigna's medical customers and overall customer relationships:
Customer Relationships (in thousands):
Total Customer Relationships8
Total Medical Customers4,8
Total customer relationships8 at third quarter 2022 grew by 4% year to date to 192.5 million.
The total medical customer base4,8 at third quarter 2022 grew to 18.0 million, an increase of 873,000 customers year to date, driven by growth in U.S. Commercial fee-based client relationships, partially offset by a decrease in U.S. Government inclusive of the divestiture of the Medicaid5 business.
HIGHLIGHTS OF SEGMENT RESULTS
See Exhibit 1 for a reconciliation of adjusted income (loss) from operations1 to shareholders' net income.
This segment includes a broad range of coordinated and point solution health services and capabilities, including pharmacy benefits services, specialty pharmacy and care services, which are provided to health plans, employers, government organizations and health care providers.
Financial Results (dollars in millions):
Adjusted Income from Operations, Pre-Tax1
Adjusted Margin, Pre-Tax9
Third quarter 2022 adjusted revenues3 increased 6% relative to third quarter 2021 reflecting strong organic growth in specialty pharmacy services.
Third quarter 2022 adjusted income from operations, pre-tax1, increased 5% relative to third quarter 2021, reflecting continued affordability improvements and business growth, partially offset by strategic investments in expanding our services portfolio and digital capabilities.
This segment includes Cigna's U.S. Commercial, U.S. Government and International Health businesses that provide comprehensive medical and coordinated solutions to clients and customers. U.S. Commercial products and services include medical, pharmacy, behavioral health, dental, vision, health advocacy programs and other products and services for insured and self-insured customers. U.S. Government solutions include Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors, and individual health insurance plans both on and off the public exchanges. International Health solutions include health care coverage in our international markets, as well as health care benefits for globally mobile individuals and employees of multinational organizations.
Financial Results (dollars in millions):
Adjusted Income from Operations, Pre-Tax1
Adjusted Margin, Pre-Tax9
Third quarter 2022 adjusted revenues3,10 grew 2% over third quarter 2021, excluding the divested Medicaid business5,6. This reflects increased specialty contributions, premium increases to cover underlying cost trends and U.S. Commercial customer growth, partially offset by lower net investment income and lower U.S. Government medical customers.
Third quarter 2022 adjusted income from operations, pre-tax1 and adjusted margin, pre-tax9 increased relative to third quarter 2021, reflecting a lower MCR7 offset by lower net investment income.
The Cigna Healthcare MCR7 of 80.8% for third quarter 2022 compares to 83.5% for third quarter 2021, reflecting lower medical costs primarily due to decreased direct COVID-19 costs. 2022 has also benefited from effective execution in pricing and affordability initiatives in our U.S. Commercial business.
Cigna Healthcare net medical costs payable11 was $4.05 billion at September 30, 2022, $4.05 billion at September 30, 2021, and $4.00 billion at December 31, 2021. Favorable prior year reserve development on a gross pre-tax basis was $278 million and $217 million through third quarter 2022 and 2021, respectively.
Corporate and Other Operations4
Corporate reflects interest expense, as well as amounts not allocated to operating segments and includes intersegment eliminations. Additionally, this discussion includes items reported in Other Operations which is comprised of Corporate Owned Life Insurance ("COLI"), our interest in a joint venture in Türkiye and the Company's run-off operations.
Financial Results (dollars in millions):
Adjusted (Loss) from Operations, Pre-Tax1
Third quarter 2022 adjusted loss from operations, pre-tax1 was greater than third quarter 2021 primarily due to the absence of income from the businesses divested in the Chubb transaction4.
Cigna's outlook for full year 2022 adjusted revenues2,3 is projected to be at least $179 billion. Cigna's outlook for full year 2022 consolidated adjusted income from operations1,2 is projected to be at least $7.23 billion, or at least $23.10 per share2. Additionally, this outlook includes the impact of expected future share repurchases and anticipated 2022 dividends.
(dollars in millions, except where noted and per share amounts)
2022 Consolidated Metrics
Projection for Full Year Ending
Adjusted Income from Operations1,2
Adjusted Income from Operations, per share1,2
Adjusted SG&A Expense Ratio2,7
Cash Flow from Operations2
Weighted Average Shares Outstanding (millions)2
Adjusted Income from Operations, Pre-Tax1,2
2022 Cigna Healthcare Metrics
Adjusted Income from Operations, Pre-Tax1,2
Total Medical Customer Growth (lives)2,8
The foregoing statements represent the Company's current estimates of Cigna's 2022 consolidated and segment adjusted income from operations1,2 and other key metrics as of the date of this release. Actual results may differ materially depending on a number of factors. Investors are urged to read the Cautionary Note Regarding Forward-Looking Statements included in this release. Management does not assume any obligation to update these estimates.
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Cigna Corporation (NYSE: CI) is a global health services company dedicated to improving the health, well-being and peace of mind of those we serve. Cigna delivers choice, predictability, affordability and access to quality care through integrated capabilities and connected, personalized solutions that advance whole person health. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Evernorth companies or their affiliates, and Express Scripts companies or their affiliates. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products.
Cigna's global footprint spans approximately 30 countries and jurisdictions, and has over 190 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.
Adjusted income (loss) from operations is a principal financial measure of profitability used by Cigna's management because it presents the underlying results of operations of Cigna's businesses and permits analysis of trends in underlying revenue, expenses and shareholders' net income. Adjusted income from operations is defined as shareholders' net income (or income before income taxes less pre-tax income (loss) attributable to noncontrolling interests for the segment metric) excluding net realized investment results, amortization of acquired intangible assets and special items. Cigna'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. Consolidated adjusted income (loss) from operations is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, shareholders' net income. See Exhibit 1 for a reconciliation of consolidated adjusted income from operations to shareholders' net income.
Management is not able to provide a reconciliation of adjusted income from operations to shareholders' net income (loss) or adjusted revenues to total revenues on a forward-looking basis because it is unable to predict, without unreasonable effort, certain components thereof including (i) future net realized investment results (from equity method investments with respect to adjusted revenues) and (ii) future special items. These items are inherently uncertain and depend on various factors, many of which are beyond Cigna's control. As such, any associated estimate and its impact on shareholders' net income and total revenues could vary materially.
The Company's outlook excludes the potential effects of any other business combinations that may occur after the date of this earnings release. The Company's outlook includes the potential effects of expected future share repurchases and anticipated 2022 dividends.
As announced in January 2021, Cigna 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 Cigna and its shareholders. The decision of whether to pay future dividends and the amount of any such dividends will be based on the Company's financial position, results of operations, cash flows, capital requirements, the requirements of applicable law and any other factors the Board of Directors may deem relevant.
The timing and actual number of shares repurchased will depend on a variety of factors, including price, general business and market conditions, and alternate uses of capital. The share repurchase program may be effected through open market purchases in compliance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended, including through Rule 10b5-1 trading plans, or privately negotiated transactions. The program may be suspended or discontinued at any time.
Adjusted revenues is used by Cigna's management because it permits analysis of trends in underlying revenue. The Company defines adjusted revenues as total revenues excluding the following adjustments: special items and Cigna'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. Adjusted revenues is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, total revenues. See Exhibit 1 for a reconciliation of consolidated adjusted revenues to total revenues.
On July 1, 2022, the Company completed the sale of its life, accident and supplemental benefits businesses in six countries (Hong Kong, Indonesia, New Zealand, South Korea, Taiwan and Thailand) to Chubb INA Holdings, Inc. ("Chubb") for approximately $5.4 billion in cash (the "Chubb transaction"); as previously agreed, we excluded our interest in a joint venture in Türkiye from the Chubb transaction.
During the fourth quarter of 2021, in connection with the Chubb transaction, we revised our business reporting structure and adjusted our segment reporting accordingly. Segment results for the three and nine months ended September, 2021 have been restated to conform to the new segment presentation. See Cigna's Current Report on Form 8-K filed on January 24, 2022 for additional information.
On January 1, 2022 the Company completed the sale of its Texas Medicaid contracts to Molina Healthcare, Inc.
The divested international4 and Medicaid5 businesses had adjusted income from operations1 of $4 million and $139 million in third quarter 2022 and third quarter 2021 respectively. Consolidated adjusted income from operations1 in third quarter 2022 and third quarter 2021 excluding the adjusted income from operations1 of the divested international4 and Medicaid5 businesses was $1,854 million and $1,797 million respectively.
Consolidated Financial Results (dollars in millions):
Consolidated Earnings, net of taxes
Net Realized Investment (Gains) Losses1
Amortization of Acquired Intangible Assets1
Adjusted Income from Operations1
Less: Adjusted Income1 from Divested International4 and Medicaid5 Businesses
Adjusted Income from Operations1 excluding Divested International4 and Medicaid5 Businesses
The divested Medicaid business5 had adjusted revenues3 in third quarter 2022 and third quarter 2021 of $14 million and $252 million respectively. Cigna Healthcare adjusted revenues3,10 in third quarter 2022 and third quarter 2021 excluding the adjusted revenues3 from the divested Medicaid business5 were $11,162 million and $10,970 million respectively.
Financial Results (dollars in millions):
Cigna Healthcare Adjusted Revenues3,10
Less: Adjusted Revenues3 from Divested Medicaid Business5
Cigna Healthcare Adjusted Revenues3,10 excluding Divested Medicaid Business5
Operating ratios are defined as follows:
The Cigna Healthcare medical care ratio ("MCR") represents medical costs as a percentage of premiums for all U.S. Commercial risk products, including medical, pharmacy, dental, stop loss and behavioral products provided through guaranteed cost or experience-rated funding arrangements, as well as Medicare Advantage, Medicare Part D, Medicare Supplement, individual on and off-exchange products, and health care products within our International Health business, within the Cigna Healthcare segment.
Adjusted SG&A expense ratio for third quarter 2022 represents enterprise selling, general and administrative expenses of $3,148 million excluding special items of $24 million as a percentage of adjusted revenue at a consolidated level. Adjusted SG&A expense ratio for the third quarter 2021 represents enterprise selling, general and administrative expenses of $3,093 million excluding special items of $13 million as a percentage of adjusted revenue at a consolidated level.
Customer relationships are defined as follows:
Total medical customers includes individuals in the Cigna Healthcare segment who meet any one of the following criteria: are covered under a medical insurance policy, managed care arrangement, or service agreement issued by Cigna; have access to Cigna's provider network for covered services under their medical plan; or have medical claims and services that are administered by Cigna.
Prior year lives include the Medicaid customers which were divested on January 1, 2022.
International Health medical customers excludes medical customers served by less than 100% owned subsidiaries and customers that are part of the businesses sold pursuant to the divestiture of the international life, accident, and supplemental benefits businesses4. Prior year lives have been restated to conform to this presentation.
Policies issued by the sold international life, accident, and supplemental benefits businesses4 and our joint venture in Türkiye have been excluded from customer relationships.
Adjusted margin, pre-tax, is calculated by dividing adjusted income (loss) from operations, pre-tax by adjusted revenues for each segment.
Cigna owns a 50% noncontrolling interest in its China joint venture. As such, the adjusted revenues for the Cigna Healthcare segment only include Cigna's 50% share of the joint venture's earnings reported in Fees and Other Revenues using the equity method of accounting under GAAP.
Medical costs payable within the Cigna Healthcare segment are presented net of reinsurance and other recoverables. The gross medical costs payable balance was $4.25 billion as of September 30, 2022, $4.26 billion as of December 31, 2021, and $4.33 billion as of September 30, 2021.
The measure "adjusted tax rate" is not determined in accordance with GAAP and should not be viewed as a substitute for the most directly comparable GAAP measure, "consolidated effective tax rate". We define adjusted tax rate as the consolidated income tax rate applicable to the Company's pre-tax income excluding pre-tax income (loss) attributable to noncontrolling interests, net realized investment results, amortization of acquired intangible assets, and special items. Cigna'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. Management is not able to provide a reconciliation to the consolidated effective tax rate on a forward-looking basis because we are unable to predict, without unreasonable effort, certain components thereof include (i) future net realized investment results and (ii) future special items.
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This press release, and oral statements made in connection with this release, may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are based on Cigna's current expectations and projections about future trends, events and uncertainties. These statements are not historical facts. Forward-looking statements may include, among others, statements concerning our projected adjusted income from operations outlook for 2022 on a consolidated, per share, and segment basis; projected adjusted revenue outlook for 2022; projected total medical customer growth over year end 2021; projected medical care and adjusted SG&A expense ratios; projected consolidated adjusted tax rate; projected cash flow from operations; future dividends; projected weighted average shares outstanding; future financial or operating performance, including our ability to deliver affordable, predictable and simple solutions for our customers and clients; future growth, business strategy and strategic or operational initiatives; economic, regulatory or competitive environments, particularly with respect to the pace and extent of change in these areas and the impact of the developing inflationary and interest rate pressures; capital deployment plans and amounts available for future deployment; our prospects for growth in the coming years; the impact of revised accounting rules related to accounting for long-duration contracts; and other statements regarding Cigna's future beliefs, expectations, plans, intentions, liquidity, cash flows, financial condition or performance. You may identify forward-looking statements by the use of words such as "believe," "expect," "project," "plan," "intend," "anticipate," "estimate," "predict," "potential," "may," "should," "will" or other words or expressions of similar meaning, although not all forward-looking statements contain such terms.
Forward-looking statements are subject to risks and uncertainties, both known and unknown, that could cause actual results to differ materially from those expressed or implied in forward-looking statements. Such risks and uncertainties include, but are not limited to: our ability to achieve our strategic and operational initiatives; our ability to adapt to changes in an evolving and rapidly changing industry; our ability to compete effectively, differentiate our products and services from those of our competitors and maintain or increase market share; price competition, inflation and other pressures that could compress our margins or result in premiums that are insufficient to cover the cost of services delivered to our customers; the potential for actual claims to exceed our estimates related to expected medical claims; our ability to develop and maintain satisfactory relationships with physicians, hospitals, other health service providers and with producers and consultants; our ability to maintain relationships with one or more key pharmaceutical manufacturers or if payments made or discounts provided decline; changes in the pharmacy provider marketplace or pharmacy networks; changes in drug pricing or industry pricing benchmarks; political, legal, operational, regulatory, economic and other risks that could affect our multinational operations, including currency exchange rates; the scale, scope and duration of the COVID-19 pandemic and its potential impact on our business, operating results, cash flows or financial condition; risks related to strategic transactions and realization of the expected benefits of such transactions, as well as integration or separation difficulties or underperformance relative to expectations; dependence on success of relationships with third parties; risk of significant disruption within our operations or among key suppliers or third parties; our ability to invest in and properly maintain our information technology and other business systems; our ability to prevent or contain effects of a potential cyberattack or other privacy or data security incident; potential liability in connection with managing medical practices and operating pharmacies, onsite clinics and other types of medical facilities; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; uncertainties surrounding participation in government-sponsored programs such as Medicare; the outcome of litigation, regulatory audits and investigations; compliance with applicable privacy, security and data laws, regulations and standards; potential failure of our prevention, detection and control systems; unfavorable economic and market conditions including the risk of a recession or other economic downturn and resulting impact on employment metrics, stock market or changes in interest rates and risks related to a downgrade in financial strength ratings of our insurance subsidiaries; the impact of our significant indebtedness and the potential for further indebtedness in the future; unfavorable industry, economic or political conditions; credit risk related to our reinsurers; as well as more specific risks and uncertainties discussed in our most recent report on Form 10-K and subsequent reports on Forms 10-Q and 8-K available through the Investor Relations section of www.cigna.com. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made, are not guarantees of future performance or results, and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Cigna undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise, except as may be required by law.
COMPARATIVE SUMMARY OF FINANCIAL RESULTS (unaudited)
(Dollars in millions, except per share amounts)
Net realized investment results from certain equity method investments
After-tax adjustments to reconcile adjusted income from operations
Net realized investment losses (gains) (2)
Amortization of acquired intangible assets
Integration and transaction-related costs (benefits)
Charge for organizational efficiency plan
(Benefits) associated with litigation matters
(Gain) on sale of businesses
Debt extinguishment costs
Adjusted income from operations
Pre-tax adjusted income (loss) from operations by segment
Corporate and Other Operations (3)
Consolidated pre-tax adjusted income from operations
Adjusted income tax expense
Consolidated after-tax adjusted income from operations
DILUTED EARNINGS PER SHARE
After-tax adjustments to reconcile to adjusted income from operations
Net realized investment losses (gains) (2)
Amortization of acquired intangible assets
Integration and transaction-related costs (benefits)
Charge for organizational efficiency plan
(Benefits) associated with litigation matters
(Gain) on sale of businesses
Debt extinguishment costs
Adjusted income from operations (4)
Weighted average shares (in thousands)
Common shares outstanding (in thousands)
SHAREHOLDERS' EQUITY at September 30,
SHAREHOLDERS' EQUITY PER SHARE at September 30,
Adjusted revenues is defined as total revenues excluding the following adjustments: special items and Cigna's share of certain realized investment results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting. These items are excluded because they are not indicative of past or future underlying performance of our businesses.
Includes the Company's share of certain realized investments results of its joint ventures reported in the Cigna Healthcare segment using the equity method of accounting.
Amounts for the three and nine months ended September 30, 2021 have been restated to reflect updated segment reporting. See Note 6 for further description of this change.
Adjusted income (loss) from operations is defined as shareholders' net income (or income before income taxes less pre-tax income (loss) attributable to noncontrolling interests for the segment metric) excluding the following adjustments: net realized investment results, amortization of acquired intangible assets and special items. Cigna'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.
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