The Cigna Group Investor Day 2026

Good morning. Welcome to The Cigna Group's 2026 Investor Day. I'm Ralph Giacobbe, Senior Vice President of Investor Relations, and on behalf of our leadership team, we want to thank you for joining us today. We're excited to share how we've deliberately shaped our portfolio to position The Cigna Group where healthcare is growing and where we can create the greatest value. Today, you'll hear about our Lead to One vision, driving greater personalization for all our members, but the greatest impact on those with complex conditions, where we have a unique and differentiated set of assets and capabilities. We'll delve into our three largest businesses, Evernorth Specialty and Care Services, Cigna Healthcare, and Evernorth Pharmacy Benefit Services, and how we'll drive profitable growth and add value across the system.

You'll hear about how our advances in data, technology, and AI, together with our clinical capabilities, enable us to deliver more personalized services, better outcomes, and greater affordability for patients and clients. We'll discuss how the strength of our businesses, together with our operational execution and disciplined capital deployment, supports our attractive long-term operating earnings growth and shareholder value creation. We look forward to your engagement throughout the day. Now, before we begin, I would note that today's presentation is being webcast live, and a full set of presentation slides are posted on our investor relations website. Also want to remind you that we will be referring to non-GAAP measures and making forward-looking statements. Relevant definitions, reconciliations, and disclaimers are available in the presentation slides. Actual results may differ materially. With that out of the way, let's get started.

Please welcome Brian Evanko. Thanks, Ralph.

Morning, everyone. Thanks for joining us for The Cigna Group's 2026 Investor Day. I'm Brian Evanko, President and CEO of the company. While this is my first Investor Day as CEO, I have been with The Cigna Group for close to 30 years. We have a lot to talk about today. We look forward to taking you through some of the great things we're doing to create value in the market, as well as for our shareholders. We're going to talk today about the strong foundation of The Cigna Group, the clear strategy that we've developed for success in the future, as well as our proven ability to execute. We look forward to today's dialogue with all of you. I'm going to hit on a few key areas here in my opening remarks.

First, our track record of evolving the company through different periods of environmental change. Secondly, the portfolio we have deliberately constructed to deliver results today, as well as grow into the future. Third, the capabilities that we have built up over a period of time that are differentiated and increasingly difficult for others to replicate. Finally, the way we execute with discipline, both operationally and financially, and how all that translates into a long-term shareholder value proposition. Let us start by talking about our track record over the past decade. The last 10 years has been characterized by what I would describe as extreme environmental disruption. We had a global pandemic, hopefully the only one in our lifetime. Affordability has reached crisis levels of healthcare. Significant changes from a policy standpoint. Think all the government-sponsored healthcare disruption.

Changes from a regulatory standpoint on both the medical side and the prescription drug side. Over all of that, The Cigna Group has made deliberate decisions on where we can create the most value in the market. We started a decade ago as predominantly a health plan focused on serving employers. In 2018, we made the decision to combine with Express Scripts, which gave us instantly a leading health services platform with both Express Scripts, our PBM, as well as Accredo, our specialty pharmacy. Subsequent to that, we made strategic choices to divest certain businesses that were non-core, such as our group life and disability or our international supplemental operations, and we made a decision to divest businesses where we did not feel like we had a competitive advantage, such as our Medicare operations last year.

Along the way, we added other capabilities, specifically to intensify our focus around complex care needs. Think some of the investments we made in specialty pharmacy capabilities over the past two to three years. This just demonstrates a track record of disciplined portfolio management to make sure the company can succeed and thrive over the long term. What resulted from this is a larger company, but a more focused company. We have actually transformed the company from 10 years ago, being a relatively small health benefits-focused company, to today, one that has the benefit of three strong growth platforms. Our specialty pharmacy capability in Evernorth, our broader pharma services platform within Evernorth and Express Scripts, and Cigna Healthcare, squarely focused on serving employers. All of these businesses have an emphasis on complex care, and that is where spending in the healthcare system is increasingly concentrating.

We have increased exposure to where there is attractive long-term secular trends. Simultaneously, we have reduced exposure to those areas we do not feel we have a competitive advantage. All of this demonstrates a consistent track record through periods of extreme change. You would have seen this morning we reaffirmed our 2026 financial outlook for all key metrics. We are tracking to deliver 14% compounded EPS growth over the last 10 years, despite an extremely disrupted external environment from the pandemic, economic shocks, significant changes in government-sponsored healthcare programs, and affordability pressures. That consistency comes from the durability of the company, our willingness to adapt, as well as the way we execute with discipline. Throughout that time period, many others in our sector had substantial financial resets and considerably more variability in their performance.

Our disciplined execution and the deliberate choices we made about our portfolio have guided us since our last Investor Day. It was about two and a half years ago, we were last together for a The Cigna Group Investor Day. Since that time period, we have navigated a very dynamic environment, and through that, our Specialty and Care Services business now represents 37% of the company's total earnings, up from just 30% two years ago. In Cigna Healthcare, our Select segment, which represents employers with 500 and fewer lives, we have grown the customer base by 12% since our last Investor Day. That is well ahead of the industry average. We have continued to return a substantial amount of capital to shareholders. Additionally, we have been able to navigate some significant policy and regulatory changes. A good example of this, last year, we introduced our revolutionary new Evernorth Signature model in Pharmacy Benefit Services.

Rebate-free, the only company that has introduced that, fully transparent, fee-based, simple, guarantees patients the lowest possible out-of-pocket. This model will fully scale starting in 2028, and it is where the industry is headed. We are proud to take a leadership position by stepping away from the competition with our Signature offering. We also were able to grow our EPS every year since our last Investor Day, which is a differentiated result relative to our sector. Our portfolio has continued to shape itself around specialty pharmacy, broader pharma services, and employer-sponsored healthcare. As CEO, there are a few areas in particular that I am focused on to ensure the long-term sustainability of the company. One is driving customer personalization with a particular emphasis on those who have the most complex healthcare needs.

A second area is how we use data, individual context with our customers, clinical capabilities, advanced analytics, and AI to drive that personalization. Finally, we will continue to invest in our people and in our culture. All those things will ensure the long-term success of The Cigna Group. We have a strong foundation to build from. We have breadth across three strong growth platforms, balance, and all of this supported by scale. Today, Cigna Healthcare represents about 40% of the company's earnings. Evernorth, our health services platform, represents about 60%, of which 37% is Specialty and Care Services. We have multiple earnings engines for growth, and they are mutually reinforced through clinical data, customer relationships, and distribution that are cross-enterprise in nature. These deep relationships give us the ability to operate at scale. In fact, today, we have some 22,000 employer relationships.

Additionally, we have industry-leading access to limited distribution drugs in our Accredo Specialty Pharmacy, with 330 and counting. This strong foundation across The Cigna Group positions us well for the future needs of the healthcare system. Right now, I would assert that the environment for healthcare is at an inflection point, and the current trajectory is unsustainable. Challenges are not just affordability, but also rising consumer expectations. We are seeing healthcare costs grow faster than inflation, faster than wages, faster than the economy. The average hospital stay is up 280% since 2000. While new prescription drugs have brought cures to many patients and significant innovative benefits, that comes at a cost, with newly approved prescription drugs over the past several years being in the $200,000-$400,000 basis on a median list price. Additionally, consumer expectations continue to increase.

Relative to other parts of their life, people want healthcare to feel convenient. They want it to feel transparent. They want it to feel personalized. They want it to feel easy. The silver lining in all of this is that the explosion of data, the advancements of technology, AI, advanced analytics now make things possible that were not possible five years ago or 10 years ago relative to meeting those increasing consumer needs. Additionally, chronic and complex spending now represents the majority of healthcare costs, and it is where costs are growing the fastest. All these trends, all these market forces have shaped The Cigna Group's forward-looking strategy. This is an important slide because it gives you a little bit of a background for what the rest of the day will go deeper on.

Lead to One is our single unifying vision that drives all 60,000-plus of The Cigna Group colleagues. The essence of Lead to One is driving personalization at scale. Personalization at scale for all the customers we serve, all the patients that we serve, all of those we are privileged to serve. This includes supporting those who are currently healthy all the way through to those with the most clinically complex healthcare needs. When we achieve this and we deliver personalization at scale, it will result in better affordability as well as improved customer experiences for those dealing with the healthcare system. This vision is enabled by three things. One is our strategic growth framework.