Total revenues for the first quarter 2024 were $57.3 billion Shareholders' net loss for the first quarter 2024 was $0.3 billion, or $0.97 per share Adjusted income from operations1 for the first quarter 2024 was $1.9 billion, or $6.47 per share 2024 outlook2 for adjusted income from operations1,2 increased to at least $28.40 per share BLOOMFIELD, Conn., May 2, 2024  /PRNewswire/ -- Global health company The Cigna Group (NYSE:CI) today reported strong first quarter 2024 results reflecting growth across its diversified portfolio of businesses. "Our strong first quarter results reflect the performance of our Evernorth and Cigna Healthcare businesses, as well as our leadership in addressing the evolving needs of those we serve with the breadth of our differentiated capabilities," said David M. Cordani, chairman and CEO of The Cigna Group. "Building on our track record of growth and continued momentum in 2024, we are pleased to increase our outlook for full-year earnings." Shareholders' net loss for first quarter 2024 was $0.3 billion, or $0.97 per share, including a non-cash after-tax investment loss of $1.8 billion, or $6.31 per share, related to the impairment of VillageMD equity securities. This compares with shareholders' net income of $1.3 billion, or $4.24 per share, for first quarter 2023. The Cigna Group's adjusted income from operations1 for first quarter 2024 was $1.9 billion, or $6.47 per share, compared with $1.6 billion, or $5.41 per share, for first quarter 2023, reflecting strong contributions from both Cigna Healthcare and Evernorth Health Services. The sale of our Medicare businesses to HCSC remains on track with the expiration of the waiting period under the Hart-Scott Rodino Act having occurred on April 17. The transaction is expected to close in the first quarter of 2025. A reconciliation of shareholders' net (loss) income to adjusted income from operations1 is provided on the following page and on Exhibit 1 of this earnings release. CONSOLIDATED HIGHLIGHTS The following table includes highlights of results and reconciliations of total revenues to adjusted revenues3 and shareholders' net (loss) income to adjusted income from operations1: Consolidated Financial Results (dollars in millions): Three Months Ended March 31, December 31, 2024 2023 2023 Total Revenues $           57,255 $           46,517 $           51,114 Net Realized Investment Results from Equity Method Investments3 (8) (38) 35 Adjusted Revenues3 $           57,247 $           46,479 $           51,149 Consolidated Earnings, net of taxes Shareholders' Net (Loss) Income $              (277) $             1,267 $             1,029 Net Realized Investment Losses1 1,827 6 58 Amortization of Acquired Intangible Assets1 322 344 360 Special Items1 3 1 552 Adjusted Income from Operations1 $             1,875 $             1,618 $             1,999 Shareholders' Net (Loss) Income, per share  $             (0.97) $               4.24 $               3.49 Adjusted Income from Operations1, per share  $               6.47 $               5.41 $               6.79   Total revenues for first quarter 2024 increased 23% from first quarter 2023, primarily driven by significant growth in Evernorth Health Services, reflecting several large client wins. Adjusted income from operations1 for first quarter 2024 increased 16% from first quarter 2023, reflecting strong contributions from Cigna Healthcare and Evernorth Health Services. The SG&A expense ratio4 and adjusted SG&A expense ratio4 were 6.5% and 6.4%, respectively, for first quarter 2024, compared to 7.6% for both ratios in first quarter 2023, reflecting business mix shift and continued operating efficiency. The debt-to-capitalization ratio was 44.3% at March 31, 2024 compared to 40.1% at December 31, 2023, primarily reflecting timing of debt issuance, in part due to the Accelerated Share Repurchase Agreements (ASR Agreements). Year to date through May 1, 2024, the company purchased 10.1 million shares of common stock for approximately $3.4 billion. This includes the initial delivery of 7.6 million shares of common stock in accordance with the ASR Agreements. Final settlement under the ASR Agreements is expected to occur in second quarter 2024. CUSTOMER RELATIONSHIPS The following table summarizes The Cigna Group's medical customers and overall customer relationships: Customer Relationships (in thousands): As of the Periods Ended March 31, December 31, 2024 2023 2023 Total Pharmacy Customers5 122,767 98,749 98,570 U.S. Healthcare 17,562 17,869 18,170 International Health 1,622 1,604 1,610 Total Medical Customers5 19,184 19,473 19,780 Behavioral Care 23,801 26,890 24,956 Dental 18,443 18,731 18,543 Medicare Part D 2,558 2,541 2,550 Total Customer Relationships5 186,753 166,384 164,399   Total pharmacy customers5 at March 31, 2024 increased 25% from December 31, 2023 to 122.8 million due to new sales and the continued expansion of relationships. Total medical customers5 at March 31, 2024 were 19.2 million, primarily reflecting a year-to-date decrease in Individual and Family Plans customers, driven by targeted pricing actions in certain geographies. Behavioral Care customers5 at March 31, 2024 were 23.8 million. The year-over-year decrease was primarily due to known non-renewal of supplemental behavioral coverage contracts, which were insignificant to total revenues and adjusted income from operations. HIGHLIGHTS OF SEGMENT RESULTS See Exhibit 1 for a reconciliation of adjusted income (loss) from operations1 to shareholders' net (loss) income.  Evernorth Health Services This segment partners with health plans, employers, governmental organizations and health care providers to solve challenges in the areas of pharmacy benefits, home delivery pharmacy, specialty pharmacy, specialty distribution, and care delivery and management solutions. 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. Financial Results (dollars in millions): Three Months Ended March 31, December 31, 2024 2023 2023 Adjusted Revenues3 $           46,226 $           36,179 $           40,519 Adjusted Income from Operations, Pre-Tax1 $             1,360 $             1,320 $             1,890 Adjusted Margin, Pre-Tax6 2.9 % 3.6 % 4.7 %   First quarter 2024 adjusted revenues3 increased 28% relative to first quarter 2023, reflecting several large client wins and continued expansion of existing relationships as well as strong organic growth in Specialty and Care Services businesses. First quarter 2024 adjusted income from operations, pre-tax1, increased 3% relative to first quarter 2023, reflecting growth in Specialty and Care Services businesses and continued affordability improvements, partially offset by planned investments related to the onboarding costs of new clients and continued advancement of our digital capabilities and care solutions. First quarter 2024 adjusted margin, pre-tax6, was 2.9% compared to 3.6% for first quarter 2023, reflecting several large client wins and business mix. Cigna Healthcare This 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 commercial medical plans and specialty benefits and solutions for insured and self-insured clients, Medicare Advantage, Medicare Supplement and Medicare Part D plans for seniors and individual health insurance plans. International Health 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): Three Months Ended March 31, December 31, 2024 2023 2023