Cigna (CI) 10-Q 31 Oct 24 2024 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2024	Oct. 25, 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		278,152,606
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2024
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Entity Central Index Key	0001739940
Document Period End Date	Sep. 30, 2024

Consolidated Statements of Inco

Consolidated Statements of Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenues
Premiums	$ 11,436	$ 10,998	$ 34,493	$ 33,062
Net investment income	85	321	696	876
TOTAL REVENUES	63,694	49,048	181,472	144,151
Benefits and expenses
Pharmacy and other service costs	47,565	33,639	133,488	98,540
Medical costs and other benefit expenses	9,527	8,927	28,482	27,007
Selling, general and administrative expenses	3,590	3,788	10,979	10,760
Amortization of acquired intangible assets	436	454	1,279	1,368
TOTAL BENEFITS AND EXPENSES	61,118	46,808	174,228	137,675
Income from operations	2,576	2,240	7,244	6,476
Interest expense and other	(376)	(365)	(1,073)	(1,086)
Loss on sale of businesses	(87)	(21)	(106)	(21)
Net realized investment losses	(921)	(14)	(2,805)	(44)
Income before income taxes	1,192	1,840	3,260	5,325
TOTAL INCOME TAXES	367	391	1,018	1,060
Net income	825	1,449	2,242	4,265
Less: Net income attributable to noncontrolling interests	86	41	232	130
SHAREHOLDERS’ NET INCOME	$ 739	$ 1,408	$ 2,010	$ 4,135
Shareholders' net income per share
Basic (in dollars per share)	$ 2.65	$ 4.79	$ 7.13	$ 14.03
Diluted (in dollars per share)	$ 2.63	$ 4.74	$ 7.05	$ 13.89
Pharmacy revenues
Revenues
Revenue from contract with customer	$ 48,284	$ 34,531	$ 135,421	$ 100,639
Fees and other revenues
Revenues
Revenue from contract with customer	$ 3,889	$ 3,198	$ 10,862	$ 9,574

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Net income	$ 825	$ 1,449	$ 2,242	$ 4,265
Other comprehensive income (loss), net of tax
Net unrealized appreciation (depreciation) on securities and derivatives	264	(192)	493	22
Net long-duration insurance and contractholder liabilities measurement adjustments	(28)	(28)	(800)	(476)
Net translation gains (losses) on foreign currencies	39	(29)	8	(32)
Postretirement benefits liability adjustment	4	8	0	25
Other comprehensive income (loss), net of tax	279	(241)	(299)	(461)
Total comprehensive income	1,104	1,208	1,943	3,804
Comprehensive income (loss) attributable to noncontrolling interests
Net income attributable to redeemable noncontrolling interests	0	37	0	116
Net income attributable to other noncontrolling interests	86	4	232	14
Other comprehensive loss attributable to redeemable noncontrolling interests	0	0	0	0
Total comprehensive income attributable to noncontrolling interests	86	41	232	130
SHAREHOLDERS' COMPREHENSIVE INCOME	$ 1,018	$ 1,167	$ 1,711	$ 3,674

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Millions		Sep. 30, 2024	Dec. 31, 2023
Assets
Cash and cash equivalents		$ 5,888	$ 7,822
Investments		864	925
Accounts receivable, net		27,846	17,722
Inventories		5,083	5,645
Other current assets		2,667	2,169
Assets of businesses held for sale		6,874	3,068
Total current assets		49,222	37,351
Long-term investments		15,270	17,985
Reinsurance recoverables		4,557	4,835
Property and equipment		3,594	3,695
Goodwill		44,374	44,259
Other intangible assets		29,791	30,863
Other assets		3,180	3,421
Separate account assets		7,651	7,430
Assets of businesses held for sale, non-current		0	2,922
TOTAL ASSETS		157,639	152,761
Liabilities
Current insurance and contractholder liabilities		5,477	5,514
Pharmacy and other service costs payable		28,801	19,815
Accounts payable		8,515	8,553
Accrued expenses and other liabilities		8,920	9,955
Short-term debt		2,572	2,775
Liabilities of businesses held for sale		2,775	2,104
Total current liabilities		57,060	48,716
Non-current insurance and contractholder liabilities		10,573	10,904
Deferred tax liabilities, net		6,794	7,173
Other non-current liabilities		3,033	3,441
Long-term debt		30,230	28,155
Separate account liabilities		7,651	7,430
Liabilities of businesses held for sale, non-current		0	591
TOTAL LIABILITIES		115,341	106,410
Contingencies — Note 16
Redeemable noncontrolling interests		0	107
Shareholders' equity
Common stock	[1]	4	4
Additional paid-in capital		31,186	30,669
Accumulated other comprehensive loss		(2,163)	(1,864)
Retained earnings		42,480	41,652
Less: Treasury stock, at cost		(29,412)	(24,238)
TOTAL SHAREHOLDERS' EQUITY		42,095	46,223
Other noncontrolling interests		203	21
Total equity		42,298	46,244
Total liabilities and equity		$ 157,639	$ 152,761
[1] Par value per share, $0.01; shares issued, 402 million as of September 30, 2024 and 400 million as of December 31, 2023; authorized shares, 600 million.

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 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

Consolidated Statements of Chan

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	222	222		332			(110)
Other comprehensive income (loss)	(461)	(461)			(461)
Net income	4,149	4,135				4,135		14
Common dividends declared	(1,093)	(1,093)				(1,093)
Repurchase of common stock	(1,785)	(1,785)		0			(1,785)
Other transactions impacting noncontrolling interests	(18)	(2)		(2)				(16)
Balance at Sep. 30, 2023	45,702	45,691	4	30,563	(2,119)	40,982	(23,739)	11
Balance at Dec. 31, 2022	66
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	0
Net income	116
Other transactions impacting noncontrolling interests	(118)
Balance at Sep. 30, 2023	64
Balance at Jun. 30, 2023	45,464	45,445	4	30,436	(1,878)	39,936	(23,053)	19
Changes in Total Equity
Effect of issuing stock for employee benefit plans	122	122		127			(5)
Other comprehensive income (loss)	(241)	(241)			(241)
Net income	1,412	1,408				1,408		4
Common dividends declared	(362)	(362)				(362)
Repurchase of common stock	(681)	(681)		0			(681)
Other transactions impacting noncontrolling interests	(12)	0		0				(12)
Balance at Sep. 30, 2023	45,702	45,691	4	30,563	(2,119)	40,982	(23,739)	11
Balance at Jun. 30, 2023	62
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	0
Net income	37
Other transactions impacting noncontrolling interests	(35)
Balance at Sep. 30, 2023	64
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	400	400		517			(117)
Other comprehensive income (loss)	(299)	(299)			(299)
Net income	2,242	2,010				2,010		232
Common dividends declared	(1,182)	(1,182)				(1,182)
Repurchase of common stock	(5,057)	(5,057)		0			(5,057)
Other transactions impacting noncontrolling interests	(50)	0		0				(50)
Balance at Sep. 30, 2024	42,298	42,095	4	31,186	(2,163)	42,480	(29,412)	203
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 Sep. 30, 2024	0
Balance at Jun. 30, 2024	41,527	41,332	4	31,048	(2,442)	42,132	(29,410)	195
Changes in Total Equity
Effect of issuing stock for employee benefit plans	136	136		138			(2)
Other comprehensive income (loss)	279	279			279
Net income	825	739				739		86
Common dividends declared	(391)	(391)				(391)
Repurchase of common stock	0	0		0			0
Other transactions impacting noncontrolling interests	(78)	0		0				(78)
Balance at Sep. 30, 2024	42,298	$ 42,095	$ 4	$ 31,186	$ (2,163)	$ 42,480	$ (29,412)	$ 203
Balance at Jun. 30, 2024	0
Change in Redeemable Noncontrolling Interests
Other comprehensive loss	0
Net income	0
Other transactions impacting noncontrolling interests	0
Balance at Sep. 30, 2024	$ 0

Consolidated Statements of Ch_2

Consolidated Statements of Changes in Total Equity (Parenthetical) - $ / shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Stockholders' Equity [Abstract]
Common dividends declared (in dollars per share)	$ 1.40	$ 1.23	$ 4.20	$ 3.69

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Millions		9 Months Ended
		Sep. 30, 2024		Sep. 30, 2023
Cash Flows from Operating Activities
Net income		$ 2,242		$ 4,265
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		2,129		2,270
Realized investment losses, net		2,805		44
Deferred income tax benefit		(351)		(303)
Loss on sale of businesses		106		21
Net changes in assets and liabilities, net of non-operating effects:
Accounts receivable, net		(10,600)		(1,916)
Inventories		577		360
Reinsurance recoverable and Other assets		(358)		281
Insurance liabilities		(214)		1,482
Pharmacy and other service costs payable		8,979		2,250
Accounts payable and Accrued expenses and other liabilities		(819)		1,337
Other, net		655		255
NET CASH PROVIDED BY OPERATING ACTIVITIES		5,151		10,346
Proceeds from investments sold:
Debt securities and equity securities		569		757
Investment maturities and repayments:
Debt securities and equity securities		585		715
Commercial mortgage loans		79		86
Other sales, maturities and repayments (primarily short-term and other long-term investments)		567		453
Investments purchased or originated:
Debt securities and equity securities		(943)		(4,005)
Commercial mortgage loans		(54)		(94)
Other (primarily short-term and other long-term investments)		(1,028)		(891)
Property and equipment purchases, net		(1,069)		(1,208)
Acquisitions, net of cash acquired		(132)		(443)
Divestitures, net of cash sold		0		13
Other, net		(485)		(117)
NET CASH USED IN INVESTING ACTIVITIES		(1,911)		(4,734)
Cash Flows from Financing Activities
Deposits and interest credited to contractholder deposit funds		120		127
Withdrawals and benefit payments from contractholder deposit funds		(180)		(139)
Net change in short-term debt		366		1,484
Repayment of long-term debt		(3,000)		(2,967)
Net proceeds on issuance of long-term debt		4,462		1,491
Repurchase of common stock		(5,012)		(1,740)
Issuance of common stock		283		113
Common stock dividend paid		(1,183)		(1,092)
Other, net		(255)		(321)
NET CASH USED IN FINANCING ACTIVITIES		(4,399)		(3,044)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash		6		2
Net (decrease) increase in cash, cash equivalents and restricted cash		(1,153)		2,570
Cash, cash equivalents and restricted cash January 1, including held for sale assets		8,337	[1]	5,976
Cash, cash equivalents and restricted cash December 31, including held for sale assets	[2]	7,184		8,546
Cash and cash equivalents reclassified to assets of businesses held for sale		(1,249)		0
Cash, cash equivalents and restricted cash and cash equivalents December 31,	[2]	5,935		8,546
Supplemental Disclosure of Cash Information:
Income taxes paid, net of refunds		839		1,380
Interest paid		$ 1,037		$ 1,019
[1] Includes $467 million reported in Assets of businesses held for sale as of January 1, 2024. Restricted cash and cash equivalents were reported in other long-term investments.

Consolidated Statements of Ca_2

Consolidated Statements of Cash Flows (Parenthetical) $ in Millions	Dec. 31, 2023 USD ($)
Held-for-Sale | Assets Of Disposal Group Including Discontinued Operation Current
Cash and cash equivalents	$ 467

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 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 for 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 entities such as governmental and non-governmental organizations, unions and associations. Cigna Healthcare also offers health and dental insurance products to individuals in the United States and select 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 includes 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 Evernorth Health Services' goodwill was allocated on a relative fair value basis during the three months ended March 31, 2024. 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 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.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 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

Accounts Receivable, Net

Accounts Receivable, Net	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Accounts Receivable, Net	Note 3 – Accounts Receivable, Net The following amounts were included within Accounts receivable, net: (In millions) September 30, 2024 December 31, 2023 Pharmaceutical manufacturers receivables $ 13,708 $ 8,169 Noninsurance customer receivables 12,615 8,044 Insurance customer receivables 2,732 2,359 Other receivables 323 272 Total $ 29,378 $ 18,844 Accounts receivable, net classified as assets of businesses held for sale (1,532) (1,122) Total $ 27,846 $ 17,722 These accounts receivable are reported net of our allowances of $4.6 billion as of September 30, 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 $88 million as of September 30, 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 began in July 2023 with an initial term of two years, followed by automatic one year renewal terms unless terminated by either party. The Facility's total capacity at inception was $1.0 billion and was amended to $1.5 billion during the three months ended June 30, 2024. Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K. We sold accounts receivable under the Facility of $1.3 billion and $1.0 billion for the three months ended September 30, 2024 and 2023, respectively, and $4.5 billion and $1.0 billion for the nine months ended September 30, 2024 and 2023, respectively. For the three and nine months ended September 30, 2024 and 2023, factoring fees paid were not material. As of September 30, 2024, there were $258 million of sold accounts receivable that have not been collected from pharmaceutical manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from pharmaceutical manufacturers. As of September 30, 2024 and December 31, 2023, there were $1.1 billion and $515 million, respectively, of collections from pharmaceutical 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.

Supplier Finance Program

Supplier Finance Program	9 Months Ended
	Sep. 30, 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 September 30, 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

Assets and Liabilities of Busin

Assets and Liabilities of Businesses Held for Sale	9 Months Ended
	Sep. 30, 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 purchase price of approximately $3.3 billion cash, subject to applicable regulatory approvals and other customary closing conditions, including adjustments to align with the final balance sheet of the divested businesses. 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) September 30, 2024 December 31, 2023 Cash and cash equivalents $ 1,249 $ 467 Investments 1,614 1,438 Accounts receivable, net 1,532 1,122 Other assets, including Goodwill (1) 2,479 2,963 Total assets of businesses held for sale 6,874 5,990 Insurance and contractholder liabilities 1,568 1,636 All other liabilities 1,207 1,059 Total liabilities of businesses held for sale $ 2,775 $ 2,695 (1) Includes Goodwill of $396 million as of September 30, 2024 and December 31, 2023. Integration and Transaction-related Costs In 2024 and 2023, the Company incurred transaction-related costs associated with the HCSC transaction. In 2023, the Company also incurred net costs mainly related to the sale of our international life, accident and supplemental benefits businesses ("Chubb transaction"). These costs incurred in both 2024 and 2023 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 $77 million pre-tax ($59 million after-tax) for the three months ended and $177 million pre-tax ($135 million after-tax) for the nine months ended September 30, 2024, compared with $13 million pre-tax ($9 million after-tax) for the three months ended and $20 million pre-tax ($15 million after-tax) for the nine months ended September 30, 2023.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 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 September 30, 2024 September 30, 2023 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders' net income $ 739 $ 739 $ 1,408 $ 1,408 Shares: Weighted average 278,457 278,457 294,058 294,058 Common stock equivalents 2,939 2,939 3,073 3,073 Total shares 278,457 2,939 281,396 294,058 3,073 297,131 Earnings per share $ 2.65 $ (0.02) $ 2.63 $ 4.79 $ (0.05) $ 4.74 Nine Months Ended September 30, 2024 September 30, 2023 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders' net income $ 2,010 $ 2,010 $ 4,135 $ 4,135 Shares: Weighted average 282,005 282,005 294,752 294,752 Common stock equivalents 3,037 3,037 2,911 2,911 Total shares 282,005 3,037 285,042 294,752 2,911 297,663 Earnings per share $ 7.13 $ (0.08) $ 7.05 $ 14.03 $ (0.14) $ 13.89 The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2024 2023 2024 2023 Anti-dilutive options 0.8 0.9 1.0 0.9 The Company held approximately 122.5 million shares of common stock in treasury at September 30, 2024, 107.4 million shares as of December 31, 2023 and 105.7 million shares as of September 30, 2023. The increase in Treasury stock as of September 30, 2024 and the reduction in weighted average shares outstanding for the three and nine months ended September 30, 2024 was driven in part by 9.3 million shares of our common stock repurchased under the accelerated share repurchase agreements (the "ASR agreements"). S ee Note 8 for additional information.

Debt

Debt	9 Months Ended
	Sep. 30, 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) September 30, 2024 December 31, 2023 Short-term debt Commercial paper $ 1,635 $ 1,237 $500 million, 0.613% Notes due March 2024 — 500 $790 million, 3.500% Notes due June 2024 (1) — 996 $900 million, 3.250% Notes due April 2025 (2) 893 — Other, including finance leases 44 42 Total short-term debt $ 2,572 $ 2,775 Long-term debt $900 million, 3.250% Notes due April 2025 (2) — 882 $1,216 million, 4.125% Notes due November 2025 (1) 1,215 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 1,462 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 3,789 3,787 $1,000 million, 5.000% Notes due May 2029 994 — $1,400 million, 2.400% Notes due March 2030 (1) (2) 1,405 1,493 $1,500 million, 2.375% Notes due March 2031 (2) 1,411 1,397 $750 million, 5.125% Notes due May 2031 745 — $45 million, 8.080% Step Down Notes due January 2033 45 45 $800 million, 5.400% Notes due March 2033 795 794 $1,250 million, 5.250% Notes due February 2034 (2) 1,256 — $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 486 487 $317 million, 5.375% Notes due February 2042 315 315 $1,500 million, 4.800% Notes due July 2046 1,468 1,467 $1,000 million, 3.875% Notes due October 2047 990 989 $3,000 million, 4.900% Notes due December 2048 2,971 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 — Other, including finance leases 50 66 Total long-term debt $ 30,230 $ 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. 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 September 30, 2024, there were no outstanding balances under these revolving credit agreements. In April 2024, The Cigna Group replaced its previous revolving credit agreements and entered into the following (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. 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 September 30, 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 $6.5 billion. Our commercial paper program size was increased from $5.0 billion to $6.5 billion during the third quarter 2024. 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 5.33% at September 30, 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 that 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. Principal Maturity Date Interest Rate Net Proceeds Redeemable Date (1) "Make whole" premium basis points over U.S. Treasury rate (2) $1,000 million May 15, 2029 5.000% $995 million April 15, 2029 15 $750 million May 15, 2031 5.125% $746 million March 15, 2031 15 $1,250 million February 15, 2034 5.250% $1,244 million November 15, 2033 20 $1,500 million February 15, 2054 5.600% $1,485 million August 15, 2053 20 (1) Redeemable at any time prior to this date at a "make whole" premium, defined below. Redeemable at par on or after this date. (2) "Make whole" premium calculated using the most directly comparable U.S. Treasury rate plus the amount of basis points set forth in this column. 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 corporate financing was $380 million for the three months ended and $1.1 billion for the nine months ended September 30, 2024, compared with $353 million for the three months ended and $1.0 billion for the nine months ended September 30, 2023. Debt Covenants The Company was in compliance with its debt covenants as of September 30, 2024.

Common and Preferred Stock

Common and Preferred Stock	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Common and Preferred Stock	Note 8 – Common and Preferred Stock Dividends The following table provides details of the Company's dividend payments: Record Date Payment Date Amount per Share Total Amount Paid (in millions) 2024 March 6, 2024 March 21, 2024 $1.40 $401 June 4, 2024 June 20, 2024 $1.40 $392 September 4, 2024 September 19, 2024 $1.40 $390 2023 March 8, 2023 March 23, 2023 $1.23 $368 June 7, 2023 June 22, 2023 $1.23 $362 September 6, 2023 September 21, 2023 $1.23 $362 On October 23, 2024, the Board of Directors declared the fourth quarter cash dividend of $1.40 per share of The Cigna Group common stock to be paid on December 19, 2024 to shareholders of record on December 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

Insurance and Contractholder Li

Insurance and Contractholder Liabilities	9 Months Ended
	Sep. 30, 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: September 30, 2024 December 31, 2023 September 30, 2023 (In millions) Current Non-current Total Current Non-current Total Total Unpaid claims and claim expenses Cigna Healthcare $ 5,006 $ 82 $ 5,088 $ 5,017 $ 75 $ 5,092 $ 5,317 Other Operations 162 150 312 99 154 253 274 Future policy benefits Cigna Healthcare 89 510 599 97 518 615 590 Other Operations 157 3,301 3,458 163 3,375 3,538 3,380 Contractholder deposit funds Cigna Healthcare 10 120 130 12 133 145 151 Other Operations 364 5,982 6,346 362 6,178 6,540 6,607 Market risk benefits 30 914 944 37 966 1,003 934 Unearned premiums 710 31 741 846 22 868 1,385 Total 6,528 11,090 17,618 6,633 11,421 18,054 Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1) (1,051) (517) (1,568) (1,119) (517) (1,636) Total insurance and contractholder liabilities $ 5,477 $ 10,573 $ 16,050 $ 5,514 $ 10,904 $ 16,418 $ 18,638 (1) Amounts classified as liabilities of businesses held for sale include $937 million of Unpaid claims, $422 million of Future policy benefits, $98 million of Unearned premiums and $111 million of Contractholder deposit funds as of September 30, 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 $4.7 billion at September 30, 2024 and $5.0 billion at September 30, 2023. Activity, net of intercompany transactions, in the unpaid claims liability for the Cigna Healthcare segment was as follows: Nine Months Ended September 30, (In millions) 2024 (1) 2023 Beginning balance $ 5,092 $ 4,176 Less: Reinsurance and other amounts recoverable 236 221 Beginning balance, net 4,856 3,955 Incurred costs related to: Current year 28,314 26,788 Prior years (422) (237) Total incurred 27,892 26,551 Paid costs related to: Current year 23,761 22,053 Prior years 4,059 3,362 Total paid 27,820 25,415 Ending balance, net 4,928 5,091 Add: Reinsurance and other amounts recoverable 160 226 Ending balance $ 5,088 $ 5,317 (1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of September 30, 2024 and December 31, 2023, $937 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: Nine Months Ended September 30, 2024 2023 (Dollars in millions) $ % (1) $ % (2) Actual completion factors and other $ 212 0.6 % $ 45 0.2 % Medical cost trend 210 0.6 192 0.6 Total favorable variance $ 422 1.2 % $ 237 0.8 % (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 primarily 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 September 30, 2024 September 30, 2023 Interest accretion rate 2.83 % 2.85 % Current discount rate 4.50 % 6.03 % Weighted average duration 9.0 years 7.0 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: Nine Months Ended September 30, (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 assumptions 1,154 1,537 Effect of assumption changes and actual variances from expected experience (2) 3 314 Issuances and lapses 1,392 822 Net premiums collected (1,065) (1,019) Interest and other (3) 680 58 Ending balance at original discount rate 11,397 10,269 Effect of end of period discount rate assumptions (865) (1,681) Ending balance (4) $ 10,532 $ 8,588 Present value of expected policy benefits Beginning balance $ 9,633 $ 8,945 Reversal of effect of discount rate assumptions 1,220 1,611 Effect of assumption changes and actual variances from expected experience (2) 203 112 Issuances and lapses 1,316 902 Benefit payments (1,096) (1,017) Interest and other (3) 580 184 Ending balance at original discount rate 11,856 10,737 Effect of discount rate assumptions (926) (1,765) Ending balance (5) $ 10,930 $ 8,972 Liability for future policy benefits $ 398 $ 384 Other (6) 201 206 Total liability for future policy benefits (1)(7) $ 599 $ 590 (1) Includes $422 million and $429 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of September 30, 2024 and December 31, 2023, respectively. (2) Includes the effect of actual variances from expectations, which decreased the total liability for future policy benefits by $(43) million and $(12) million, respectively, for the nine months ended September 30, 2024 and September 30, 2023. (3) 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. (4) As of September 30, 2024 and September 30, 2023, undiscounted expected future gross premiums were $20.7 billion and $18.5 billion, respectively. As of September 30, 2024 and September 30, 2023, discounted expected future gross premiums were $14.4 billion and $12.5 billion, respectively. (5) As of September 30, 2024 and September 30, 2023, undiscounted expected future policy benefits were $15.6 billion and $13.1 billion, respectively. (6) The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off. (7) $73 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of September 30, 2024 and September 30, 2023, respectively, relate to the liability for future policy benefits. Additionally, $78 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of September 30, 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 September 30, 2024 September 30, 2023 Interest accretion rate 5.64 % 5.64 % Current discount rate 4.81 % 5.73 % Weighted average duration 11.3 years 10.9 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 $0.4 billion as of both September 30, 2024 and September 30, 2023. Future policy benefits excluding deferred profit liability were $3.1 billion as of September 30, 2024, $3.0 billion as of September 30, 2023, and $3.2 billion as of both December 31, 2023, and December 31, 2022. The decrease in future policy benefit reserve as of both September 30, 2024 and September 30, 2023 was primarily driven by benefit payments and for the nine months ended September 30, 2023 current discount rate increases were an additional factor contributing to the decrease in future policy benefit reserve. For both periods, the decreases were partially offset by interest accretion. Undiscounted expected future policy benefits were $4.3 billion as of September 30, 2024 and $4.5 billion as of September 30, 2023. As of September 30, 2024 and September 30, 2023, $0.9 billion and $1.0 billion, respectively, of the future policy benefit reserve was recoverable through treaties with external reinsurers. Contractholder Deposit Funds Contractholder deposit fund liabilities within Other Operations were $6.3 billion as of September 30, 2024, $6.5 billion as of December 31, 2023, $6.6 billion as of September 30, 2023 and $6.7 billion as of 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 September 30, 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%, $2.9 billion and $2.8 billion, respectively. The comparative amounts as of September 30, 2023 were 3.27%, $3.1 billion and $2.8 billion, respectively. More than 99% of the $4.0 billion liability as of September 30, 2024 and the $4.1 billion liability as of September 30, 2023 not reinsured externally is for contracts with guaranteed interest rates of 3% - 4%, and approximately $1.1 billion and $1.2 billion, as of September 30, 2024 and September 30, 2023, respectively, represented contracts with policies at the guarantee. As of both September 30, 2024 and September 30, 2023, $1.2 billion was 50-150 basis points ("bps") above the guarantee and the remaining $1.7 billion represented contracts above the guarantee that pay the policyholder based on the greater of a guaranteed minimum cash value or the actual cash value. As of both September 30, 2024 and September 30, 2023, 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: Nine Months Ended September 30, (Dollars in millions) 2024 2023 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 (7) (15) Changes due to capital markets versus expected (78) (352) Changes due to policyholder behavior versus expected (26) (1) Assumption changes 37 (16) Balance, end of period, before the effect of changes in nonperformance risk (own credit risk) 1,011 995 Nonperformance risk (own credit risk), end of period (67) (61) Balance, end of period $ 944 $ 934 Reinsured market risk benefit, end of period $ 1,008 $ 993 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) September 30, 2024 September 30, 2023 Net amount at risk $ 1,361 $ 1,986 Average attained age of contractholders (weighted by exposure) 77.6 years 75.9 years

Reinsurance

Reinsurance	9 Months Ended
	Sep. 30, 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 September 30, 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 collateral Total Ongoing Operations A- equivalent and higher current ratings (2) $ — $ 7 $ 235 $ 242 BBB- to BBB+ equivalent current credit ratings (2) — — 62 62 Not rated 143 11 3 157 Total recoverables related to ongoing operations 143 18 300 461 Acquisition, disposition or run-off activities BBB+ equivalent and higher current ratings (2) Lincoln National Life and Lincoln Life & Annuity of New York — 2,548 — 2,548 Empower Annuity Insurance Company — — 123 123 Prudential Insurance Company of America 320 — — 320 Life Insurance Company of North America — 311 — 311 Other 155 19 14 188 Not rated — 6 4 10 Total recoverables related to acquisition, disposition or run-off activities 475 2,884 141 3,500 Total reinsurance recoverables before market risk benefits $ 618 $ 2,902 $ 441 $ 3,961 Allowance for uncollectible reinsurance (30) Market risk benefits 1,008 Total reinsurance recoverables (3) $ 4,939 (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 $188 million of current reinsurance recoverables that are reported in Other current assets and $194 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 $3.0 billion remaining at September 30, 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) September 30, 2024 December 31, 2023 Collateral and Other Terms at September 30, 2024 Berkshire $ 836 $ 873 80% were secured by assets in a trust. Sun Life Assurance Company of Canada 75 92 Liberty Re (Bermuda) Ltd. 87 104 100% were secured by assets in a trust. SCOR SE 29 31 65% were secured by a letter of credit. Market risk benefits (2) $ 1,027 $ 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 $19 million as of September 30, 2024 and $19 million as of December 31, 2023. These amounts are excluded from market risk benefits as of September 30, 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 and nine months ended September 30, 2024 and September 30, 2023.

Investments

Investments	9 Months Ended
	Sep. 30, 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: September 30, 2024 December 31, 2023 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 596 $ 9,285 $ 9,881 $ 590 $ 9,265 $ 9,855 Equity securities 29 488 517 31 3,331 3,362 Commercial mortgage loans 165 1,295 1,460 182 1,351 1,533 Policy loans — 1,163 1,163 — 1,211 1,211 Other long-term investments — 4,545 4,545 — 4,181 4,181 Short-term investments 182 — 182 206 — 206 Total $ 972 $ 16,776 $ 17,748 $ 1,009 $ 19,339 $ 20,348 Investments classified as assets of businesses held for sale (1) (108) (1,506) (1,614) (84) (1,354) (1,438) Investments per Consolidated Balance Sheets $ 864 $ 15,270 $ 16,134 $ 925 $ 17,985 $ 18,910 (1) Investments related to the HCSC transaction that were held for sale as of September 30, 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 September 30, 2024: (In millions) Amortized Fair Due in one year or less $ 784 $ 695 Due after one year through five years 3,897 3,806 Due after five years through ten years 3,117 3,033 Due after ten years 2,097 1,994 Mortgage and other asset-backed securities 378 353 Total $ 10,273 $ 9,881 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 Allowance for Credit Loss Unrealized Unrealized Fair September 30, 2024 Federal government and agency $ 273 $ — $ 21 $ (5) $ 289 State and local government 37 — 2 (1) 38 Foreign government 373 — 12 (9) 376 Corporate 9,212 (104) 204 (487) 8,825 Mortgage and other asset-backed 378 — 3 (28) 353 Total $ 10,273 $ (104) $ 242 $ (530) $ 9,881 December 31, 2023 Federal government and agency $ 251 $ — $ 24 $ (8) $ 267 State and local government 37 — 2 (1) 38 Foreign government 355 — 10 (13) 352 Corporate 9,338 (33) 158 (630) 8,833 Mortgage and other asset-backed 398 — 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. September 30, 2024 December 31, 2023 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 202 $ 205 $ (3) 112 $ 330 $ 338 $ (8) 142 Below investment grade 91 100 (9) 155 161 170 (9) 135 More than one year Investment grade 5,076 5,543 (467) 1,382 5,441 6,036 (595) 1,590 Below investment grade 487 538 (51) 278 701 775 (74) 486 Total $ 5,856 $ 6,386 $ (530) 1,927 $ 6,633 $ 7,319 $ (686) 2,353 Equity Securities The following table provides the values of the Company's equity security investments: September 30, 2024 December 31, 2023 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 657 $ 49 $ 656 $ 51 Equity securities with no readily determinable fair value 3,117 468 3,248 3,311 Total $ 3,774 $ 517 $ 3,904 $ 3,362 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. The annual portfolio review performed in the second quarter of 2024 confirmed ongoing strong overall credit quality in line with the previous year's results. 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) September 30, 2024 December 31, 2023 Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Below 60% $ 645 2.15 $ 802 2.13 60% to 79% 574 1.85 574 1.77 80% to 100% 241 0.92 157 0.65 Total $ 1,460 1.81 67 % $ 1,533 1.82 64 % 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 flow estimates 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) September 30, 2024 December 31, 2023 Real estate investments $ 1,760 $ 1,606 Securities partnerships 2,578 2,400 Other 207 175 Total $ 4,545 $ 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 September 30, 2024, the notional value of interest rate swap contracts increased to $2.1 billion compared to $1.5 billion as of December 31, 2023. There have been no other material changes to the Company's derivative financial instruments during the nine months ended September 30, 2024. 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 September 30, 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 Losses The following realized gains and losses on investments exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2024 2023 2024 2023 Net realized investment gains (losses), excluding credit (loss)/recovery and other investment write-downs $ 25 $ (9) $ 32 $ (29) Credit (loss)/recovery and other investment write-downs (946) (5) (2,837) (15) Net realized investment (losses), before income taxes $ (921) $ (14) $ (2,805) $ (44)

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 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 Significant Other Observable Inputs Significant Unobservable Inputs Total September 30, December 31, 2023 September 30, December 31, 2023 September 30, December 31, 2023 September 30, December 31, 2023 Financial assets at fair value Debt securities Federal government and agency $ 168 $ 130 $ 121 $ 137 $ — $ — $ 289 $ 267 State and local government — — 38 38 — — 38 38 Foreign government — — 376 352 — — 376 352 Corporate — — 8,448 8,432 377 401 8,825 8,833 Mortgage and other asset-backed — — 307 319 46 46 353 365 Total debt securities 168 130 9,290 9,278 423 447 9,881 9,855 Equity securities (1) 1 4 48 47 — — 49 51 Short-term investments — — 182 206 — — 182 206 Derivative assets — — 129 131 — 1 129 132 Financial liabilities at fair value Derivative liabilities $ — $ — $ 5 $ 4 $ — $ — $ 5 $ 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 of Unobservable Adjustment Range (Weighted Average by Quantity) as of (Fair value in millions) September 30, 2024 December 31, 2023 Unobservable Input September 30, 2024 September 30, 2024 December 31, 2023 Debt securities Corporate $ 377 $ 401 Liquidity 60 - 1495 (380) bps 70 - 1235 (310) bps Mortgage and other asset-backed securities 46 46 Liquidity 100 - 635 (320) bps 95 - 640 (310) bps Total Level 3 debt securities $ 423 $ 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 September 30, Nine Months Ended (In millions) 2024 2023 2024 2023 Debt and Equity Securities Beginning balance $ 397 $ 454 $ 447 $ 447 Losses included in Shareholders' net income (10) (1) (71) (1) Gains (losses) included in Other comprehensive income (loss) 8 (5) 3 (5) Purchases, sales and settlements Purchases 4 6 15 10 Sales (2) — (2) — Settlements (4) (5) (19) (32) Total purchases, sales and settlements (2) 1 (6) (22) Transfers into / (out of) Level 3 Transfers into Level 3 32 — 63 71 Transfers out of Level 3 (2) (13) (13) (54) Total transfers into / (out of) Level 3 30 (13) 50 17 Ending balance $ 423 $ 436 $ 423 $ 436 Total losses included in Shareholders' net income attributable to instruments held at the reporting date $ (9) $ (1) $ (71) $ (1) Change in unrealized gain or (loss) included in Other comprehensive income (loss) for assets held at the end of the reporting period $ 8 $ (4) $ 3 $ (9) Total gains and losses included in Shareholders' net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income. Gains and losses included in Other comprehensive income (loss), net of tax in the tables above are reflected in Net unrealized appreciation (depreciation) on securities and derivatives in the Consolidated Statements of Comprehensive Income. Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases and is typically observed through the widening of liquidity spreads. Transfers between Level 2 and Level 3 during 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 nine months ended September 30, 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 Significant Other Observable Inputs Significant Unobservable Inputs Total (In millions) September 30, 2024 December 31, 2023 September 30, 2024 December 31, 2023 September 30, 2024 December 31, 2023 September 30, 2024 December 31, 2023 Guaranteed separate accounts (See Note 16) $ 247 $ 226 $ 353 $ 352 $ — $ — $ 600 $ 578 Non-guaranteed separate accounts (1) 166 158 6,007 5,797 227 217 6,400 6,172 Subtotal $ 413 $ 384 $ 6,360 $ 6,149 $ 227 $ 217 7,000 6,750 Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1) 651 680 Total $ 7,651 $ 7,430 (1) Non-guaranteed separate accounts include $4.0 billion as of both September 30, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both September 30, 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 and nine months ended September 30, 2024 or 2023. Separate account investments in securities partnerships, real estate, real estate funds 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 of Unfunded Commitment as of September 30, 2024 Redemption Frequency Redemption Notice (In millions) September 30, 2024 December 31, 2023 Securities partnerships $ 413 $ 419 $ 224 Not applicable Not applicable Real estate and real estate funds 237 258 3 Quarterly 30 - 90 days Hedge funds 1 3 — Up to annually, varying by fund 30 - 90 days Total $ 651 $ 680 $ 227 As of September 30, 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 nine months ended September 30, 2024, we determined our investment in VillageMD was fully impaired and recorded a $2.7 billion loss in Net realized investment losses in the Company's Consolidated Statements of Income. For the nine months ended September 30, 2023, impairments recognized requiring the assets and liabilities described above to be measured at fair value were not material. Observable price changes for equity securities with no readily determinable fair value were not material for the nine months ended September 30, 2024 and September 30, 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 Hierarchy September 30, 2024 December 31, 2023 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,394 $ 1,460 $ 1,430 $ 1,533 Long-term debt, including current maturities, excluding finance leases Level 2 $ 29,854 $ 31,073 $ 28,033 $ 29,585

Variable Interest Entities

Variable Interest Entities	9 Months Ended
	Sep. 30, 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 September 30, 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.

Accumulated Other Comprehensive

Accumulated Other Comprehensive Income (Loss)	9 Months Ended
	Sep. 30, 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 (depreciation) 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 income in the same period that the related pre-tax AOCI reclassifications are recognized. Shareholders' other comprehensive loss, net of tax, for the three and nine months ended September 30, 2024 and September 30, 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 Nine Months Ended (In millions) 2024 2023 2024 2023 Securities and Derivatives Beginning balance $ 400 $ (118) $ 171 $ (332) Unrealized appreciation (depreciation) on securities and derivatives 319 (257) 568 2 Tax (expense) benefit (65) 57 (133) (9) Net unrealized appreciation (depreciation) on securities and derivatives 254 (200) 435 (7) Reclassification adjustment for losses included in Shareholders' net income (Net realized investment losses) 12 12 73 38 Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses) — (1) — (1) Reclassification adjustment for tax (benefit) included in Shareholders' net income (2) (3) (15) (8) Net losses reclassified from AOCI to Shareholders' net income 10 8 58 29 Other comprehensive income (loss), net of tax 264 (192) 493 22 Ending balance $ 664 $ (310) $ 664 $ (310) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Net long-duration insurance and contractholder liabilities measurement adjustments Beginning balance $ (1,743) $ (704) $ (971) $ (256) Current period change in discount rate for certain long-duration liabilities (34) (27) (1,054) (585) Tax benefit 3 12 265 149 Net current period change in discount rate for certain long-duration liabilities (31) (15) (789) (436) Current period change in instrument-specific credit risk for market risk benefits 3 (17) (15) (50) Tax benefit — 4 4 10 Net current period change in instrument-specific credit risk for market risk benefits 3 (13) (11) (40) Other comprehensive (loss), net of tax (28) (28) (800) (476) Ending balance $ (1,771) $ (732) $ (1,771) $ (732) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Translation of foreign currencies Beginning balance $ (180) $ (157) $ (149) $ (154) Translation of foreign currencies 41 (31) 13 (36) Tax (expense) benefit (2) 2 (5) 4 Other comprehensive income (loss), net of tax 39 (29) 8 (32) Ending balance $ (141) $ (186) $ (141) $ (186) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Postretirement benefits liability Beginning balance $ (919) $ (899) $ (915) $ (916) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other) 9 11 24 35 Reclassification adjustment for tax (benefit) included in Shareholders' net income (5) (3) (8) (9) Net adjustments reclassified from AOCI to Shareholders' net income 4 8 16 26 Valuation update (1) — (21) (2) Tax benefit 1 — 5 1 Net change due to valuation update — — (16) (1) Other comprehensive income, net of tax 4 8 — 25 Ending balance $ (915) $ (891) $ (915) $ (891) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Total Accumulated other comprehensive loss Beginning balance $ (2,442) $ (1,878) $ (1,864) $ (1,658) Shareholders' other comprehensive income (loss), net of tax 279 (241) (299) (461) Ending balance $ (2,163) $ (2,119) $ (2,163) $ (2,119)

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Note 15 – Income Taxes Income Tax Expense The 30.8% and 31.2% effective tax rates for the three and nine months ended September 30, 2024, respectively, were higher than the 21.3% and 19.9% rates for the three and nine months ended September 30, 2023, respectively. These increases were primarily driven by the establishment of a valuation allowance on the tax benefit related to the impairment of equity securities. As of September 30, 2024, we had approximately $836 million in deferred tax assets ("DTAs") associated with the impairment of equity securities as well as unrealized investment losses which are partially recorded in Accumulated other comprehensive loss. A valuation allowance of $635 million, established in the nine months ended September 30, 2024, drove the higher effective tax rate and was almost entirely related to the impairment of equity securities discussed in Note 11 to the Consolidated Financial Statements. 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 ability and intent to hold certain securities until recovery. We continue to monitor and evaluate the need for any additional valuation allowance.

Contingencies and Other Matters

Contingencies and Other Matters	9 Months Ended
	Sep. 30, 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 September 30, 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 September 30, 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 September 30, 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 September 30, 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 nine months ended September 30, 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 retained the right to appeal the pricing-related claims that were previously dismissed by the court and Express Scripts retained 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. Express Scripts filed its answering appellate brief on July 24, 2024. Oral arguments before the Second Circuit were held on October 22, 2024.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 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 reflect the underlying results of business operations and facilitate 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 September 30, Nine Months Ended September 30, 2024 2023 2024 2023 (In millions) Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Impairment of dividend receivable $ 182 $ 138 $ — $ — $ 182 $ 138 $ — $ — Integration and transaction-related costs 77 59 13 9 177 135 20 15 Loss on sale of businesses 87 62 21 19 106 19 21 19 Deferred tax expenses, net — 41 — — — 75 — — Charges associated with litigation matters — — 201 171 — — 201 171 Total impact from special items $ 346 $ 300 $ 235 $ 199 $ 465 $ 367 $ 242 $ 205 Summarized segment financial information was as follows: (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Three months ended September 30, 2024 Revenues from external customers $ 51,552 $ 11,919 $ 137 $ 1 $ 63,609 Intersegment revenues 1,045 1,279 18 (2,342) Net investment (loss) income (142) 142 79 6 85 Total revenues 52,455 13,340 234 (2,335) 63,694 Net realized investment results from certain equity method investments — (177) — — (177) Special item related to impairment of dividend receivable 182 — — — 182 Adjusted revenues $ 52,637 $ 13,163 $ 234 $ (2,335) $ 63,699 Income (loss) before income taxes $ 631 $ 1,073 $ (10) $ (502) $ 1,192 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (99) — — — (99) Net realized investment losses (gains) (1) 748 (8) 4 — 744 Amortization of acquired intangible assets 414 22 — — 436 Special items Impairment of dividend receivable 182 — — — 182 Integration and transaction-related costs — — — 77 77 Loss on sale of businesses — 87 — — 87 Pre-tax adjusted income (loss) from operations $ 1,876 $ 1,174 $ (6) $ (425) $ 2,619 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Three months ended September 30, 2023 Revenues from external customers $ 37,230 $ 11,426 $ 71 $ — $ 48,727 Intersegment revenues 1,303 1,136 — (2,439) Net investment income 63 176 76 6 321 Total revenues 38,596 12,738 147 (2,433) 49,048 Net realized investment results from certain equity method investments — 30 — — 30 Adjusted revenues $ 38,596 $ 12,768 $ 147 $ (2,433) $ 49,078 Income (loss) before income taxes $ 1,272 $ 1,019 $ (3) $ (448) $ 1,840 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (44) — — — (44) Net realized investment losses (1) 1 35 8 — 44 Amortization of acquired intangible assets 443 11 — — 454 Special items Integration and transaction-related costs — — — 13 13 Loss on sale of businesses — — 21 — 21 Charges associated with litigation matters 44 157 — — 201 Pre-tax adjusted income (loss) from operations $ 1,716 $ 1,222 $ 26 $ (435) $ 2,529 (1) Includes Net realized investment losses/gains 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. (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Nine months ended September 30, 2024 Revenues from external customers $ 144,689 $ 35,752 $ 333 $ 2 $ 180,776 Intersegment revenues 3,558 3,606 63 (7,227) Net investment (loss) income (18) 463 231 20 696 Total revenues 148,229 39,821 627 (7,205) 181,472 Net realized investment results from certain equity method investments — (238) — — (238) Special item related to impairment of dividend receivable 182 — — — 182 Adjusted revenues $ 148,411 $ 39,583 $ 627 $ (7,205) $ 181,416 Income (loss) before income taxes $ 1,494 $ 3,221 $ (9) $ (1,446) $ 3,260 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (271) — — — (271) Net realized investment losses (1) 2,203 359 5 — 2,567 Amortization of acquired intangible assets 1,247 32 — — 1,279 Special items Impairment of dividend receivable 182 — — — 182 Integration and transaction-related costs — — — 177 177 Loss on sale of businesses — 106 — — 106 Pre-tax adjusted income (loss) from operations $ 4,855 $ 3,718 $ (4) $ (1,269) $ 7,300 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Nine months ended September 30, 2023 Revenues from external customers $ 108,462 $ 34,581 $ 232 $ — $ 143,275 Intersegment revenues 4,343 3,143 — (7,486) Net investment income 175 454 230 17 876 Total revenues 112,980 38,178 462 (7,469) 144,151 Net realized investment results from certain equity method investments — 22 — — 22 Adjusted revenues $ 112,980 $ 38,200 $ 462 $ (7,469) $ 144,173 Income (loss) before income taxes $ 3,318 $ 3,252 $ 47 $ (1,292) $ 5,325 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (140) (2) — — (142) Net realized investment losses (1) — 64 2 — 66 Amortization of acquired intangible assets 1,330 38 — — 1,368 Special items Integration and transaction-related costs — — — 20 20 Loss on sale of businesses — — 21 — 21 Charges associated with litigation matters 44 157 — — 201 Pre-tax adjusted income (loss) from operations $ 4,552 $ 3,509 $ 70 $ (1,272) $ 6,859 (1) Includes Net realized investment losses/gains 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 September 30, Nine Months Ended September 30, (In millions) 2024 2023 2024 2023 Products (Pharmacy revenues) (ASC 606) Network revenues $ 27,353 $ 16,926 $ 76,795 $ 49,080 Home delivery and specialty revenues 18,909 16,324 53,384 48,943 Other revenues 2,990 2,390 8,433 6,506 Total Evernorth Health Services 49,252 35,640 138,612 104,529 Total Other Operations 14 — 47 — Intercompany eliminations (982) (1,109) (3,238) (3,890) Total Pharmacy revenues 48,284 34,531 135,421 100,639 Insurance premiums (ASC 944) Cigna Healthcare (1) U.S. Healthcare Employer insured 4,382 4,144 13,125 12,315 Medicare Advantage 2,110 2,189 6,604 6,605 Stop loss 1,689 1,548 5,022 4,565 Individual and Family Plans 1,001 1,269 3,016 3,770 Other 1,203 927 3,681 3,091 U.S. Healthcare 10,385 10,077 31,448 30,346 International Health 911 834 2,687 2,440 Total Cigna Healthcare 11,296 10,911 34,135 32,786 Other 122 70 285 225 Intercompany eliminations 18 17 73 51 Total Premiums 11,436 10,998 34,493 33,062 Services (Fees) (ASC 606) Evernorth Health Services 3,314 2,862 9,508 8,199 Cigna Healthcare 1,671 1,639 4,850 4,847 Other Operations 15 1 57 3 Other revenues 267 43 509 172 Intercompany eliminations (1,378) (1,347) (4,062) (3,647) Total Fees and other revenues 3,889 3,198 10,862 9,574 Total revenues from external customers $ 63,609 $ 48,727 $ 180,776 $ 143,275 (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 and nine months ended September 30, 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 $2.0 billion as of September 30, 2024 and $1.6 billion as of December 31, 2023. Major customers. Revenues from a single pharmacy benefit client were approximately 16% of consolidated revenues for the three and nine months ended September 30, 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 10% and 11% of consolidated revenues for the three and nine months ended September 30, 2024, respectively. 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.

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended	9 Months Ended
	Sep. 30, 2024 shares	Sep. 30, 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 September 12, 2024, Noelle K. Eder, Executive Vice President, Global Chief Information Officer of The Cigna Group, adopted a 10b5-1 plan. Ms. Eder's plan provides for (i) the sale of up to 5,981 shares of The Cigna Group common stock, (ii) the sale of shares of The Cigna Group common stock issuable upon vesting of a performance award (the actual number of shares depends on actual performance achieved and may range from 0% to 200% of the 6,300 shares subject to the award at the target level of performance), and (iii) the exercise of vested stock options and the associated sale of up to 7,026 shares of The Cigna Group common stock, in each case through May 2, 2025.
Name	Noelle K. Eder
Title	Executive Vice President, Global Chief Information Officer of The Cigna Group
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	September 12, 2024
Arrangement Duration	232 days
Trading Arrangement, Common Stock [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	5,981	5,981
Trading Arrangement, Common Stock Issuable Upon Vesting Of Performance Award At Target Level [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	6,300	6,300
Trading Arrangement, Stock Options [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	7,026	7,026
Trading Arrangement, Common Stock Issuable Upon Vesting Of Performance Award At Zero PercentTarget Level [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	0	0
Trading Arrangement, Common Stock Issuable Upon Vesting Of Performance Award At 200 Percent Target Level [Member] | Noelle Eder [Member]
Trading Arrangements, by Individual
Aggregate Available	12,600	12,600

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 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
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	Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.As of September 30, 2024, there were $258 million of sold accounts receivable that have not been collected from pharmaceutical manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from pharmaceutical manufacturers. As of September 30, 2024 and December 31, 2023, there were $1.1 billion and $515 million, respectively, of collections from pharmaceutical 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. 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.
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. The annual portfolio review performed in the second quarter of 2024 confirmed ongoing strong overall credit quality in line with the previous year's results. 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.
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 Total gains and losses included in Shareholders' net income in the tables above are reflected in the Consolidated Statements of Income as Net realized investment losses and Net investment income. Gains and losses included in Other comprehensive income (loss), net of tax in the tables above are reflected in Net unrealized appreciation (depreciation) on securities and derivatives in the Consolidated Statements of Comprehensive Income. Transfers into or out of the Level 3 category occur when unobservable inputs, such as the Company's best estimate of what a market participant would use to determine a current transaction price, become more or less significant to the fair value measurement. Market activity typically decreases during periods of economic uncertainty and this decrease in activity reduces the availability of market observable data. As a result, the level of unobservable judgment that must be applied to the pricing of certain instruments increases 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.
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 nine months ended September 30, 2024 and 2023 was primarily driven by changes in the market values of the underlying separate account 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 income in the same period that the related pre-tax AOCI reclassifications are recognized.
Guarantees	Financial Guarantees: Retiree and Life Insurance Benefits Certain Other Guarantees 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 reflect the underlying results of business operations and facilitate 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.

Receivables, Loans, Notes Recei

Receivables, Loans, Notes Receivable, and Others (Policies)	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Accounts Receivable	Further information regarding the accounting policy for the Facility can be found in Note 3 in the Company's 2023 Form 10-K.As of September 30, 2024, there were $258 million of sold accounts receivable that have not been collected from pharmaceutical manufacturers and have been removed from the Company's Consolidated Balance Sheets. At December 31, 2023, all sold accounts receivable had been collected from pharmaceutical manufacturers. As of September 30, 2024 and December 31, 2023, there were $1.1 billion and $515 million, respectively, of collections from pharmaceutical 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.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Accounts Receivable, Net	The following amounts were included within Accounts receivable, net: (In millions) September 30, 2024 December 31, 2023 Pharmaceutical manufacturers receivables $ 13,708 $ 8,169 Noninsurance customer receivables 12,615 8,044 Insurance customer receivables 2,732 2,359 Other receivables 323 272 Total $ 29,378 $ 18,844 Accounts receivable, net classified as assets of businesses held for sale (1,532) (1,122) Total $ 27,846 $ 17,722

Assets and Liabilities of Bus_2

Assets and Liabilities of Businesses Held for Sale (Tables)	9 Months Ended
	Sep. 30, 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) September 30, 2024 December 31, 2023 Cash and cash equivalents $ 1,249 $ 467 Investments 1,614 1,438 Accounts receivable, net 1,532 1,122 Other assets, including Goodwill (1) 2,479 2,963 Total assets of businesses held for sale 6,874 5,990 Insurance and contractholder liabilities 1,568 1,636 All other liabilities 1,207 1,059 Total liabilities of businesses held for sale $ 2,775 $ 2,695 (1) Includes Goodwill of $396 million as of September 30, 2024 and December 31, 2023.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 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 September 30, 2024 September 30, 2023 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders' net income $ 739 $ 739 $ 1,408 $ 1,408 Shares: Weighted average 278,457 278,457 294,058 294,058 Common stock equivalents 2,939 2,939 3,073 3,073 Total shares 278,457 2,939 281,396 294,058 3,073 297,131 Earnings per share $ 2.65 $ (0.02) $ 2.63 $ 4.79 $ (0.05) $ 4.74 Nine Months Ended September 30, 2024 September 30, 2023 (Shares in thousands, dollars in millions, except per share amounts) Basic Effect of Diluted Basic Effect of Diluted Shareholders' net income $ 2,010 $ 2,010 $ 4,135 $ 4,135 Shares: Weighted average 282,005 282,005 294,752 294,752 Common stock equivalents 3,037 3,037 2,911 2,911 Total shares 282,005 3,037 285,042 294,752 2,911 297,663 Earnings per share $ 7.13 $ (0.08) $ 7.05 $ 14.03 $ (0.14) $ 13.89
Outstanding Employee Stock Options Not Included in the Computation of Diluted Earnings Per Share	The following outstanding employee stock options were not included in the computation of diluted earnings per share because their effect was anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2024 2023 2024 2023 Anti-dilutive options 0.8 0.9 1.0 0.9

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 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) September 30, 2024 December 31, 2023 Short-term debt Commercial paper $ 1,635 $ 1,237 $500 million, 0.613% Notes due March 2024 — 500 $790 million, 3.500% Notes due June 2024 (1) — 996 $900 million, 3.250% Notes due April 2025 (2) 893 — Other, including finance leases 44 42 Total short-term debt $ 2,572 $ 2,775 Long-term debt $900 million, 3.250% Notes due April 2025 (2) — 882 $1,216 million, 4.125% Notes due November 2025 (1) 1,215 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 1,462 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 3,789 3,787 $1,000 million, 5.000% Notes due May 2029 994 — $1,400 million, 2.400% Notes due March 2030 (1) (2) 1,405 1,493 $1,500 million, 2.375% Notes due March 2031 (2) 1,411 1,397 $750 million, 5.125% Notes due May 2031 745 — $45 million, 8.080% Step Down Notes due January 2033 45 45 $800 million, 5.400% Notes due March 2033 795 794 $1,250 million, 5.250% Notes due February 2034 (2) 1,256 — $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 486 487 $317 million, 5.375% Notes due February 2042 315 315 $1,500 million, 4.800% Notes due July 2046 1,468 1,467 $1,000 million, 3.875% Notes due October 2047 990 989 $3,000 million, 4.900% Notes due December 2048 2,971 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 — Other, including finance leases 50 66 Total long-term debt $ 30,230 $ 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.
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 that 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. Principal Maturity Date Interest Rate Net Proceeds Redeemable Date (1) "Make whole" premium basis points over U.S. Treasury rate (2) $1,000 million May 15, 2029 5.000% $995 million April 15, 2029 15 $750 million May 15, 2031 5.125% $746 million March 15, 2031 15 $1,250 million February 15, 2034 5.250% $1,244 million November 15, 2033 20 $1,500 million February 15, 2054 5.600% $1,485 million August 15, 2053 20 (1) Redeemable at any time prior to this date at a "make whole" premium, defined below. Redeemable at par on or after this date. (2) "Make whole" premium calculated using the most directly comparable U.S. Treasury rate plus the amount of basis points set forth in this column.

Common and Preferred Stock (Tab

Common and Preferred Stock (Tables)	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Dividend Payments	The following table provides details of the Company's dividend payments: Record Date Payment Date Amount per Share Total Amount Paid (in millions) 2024 March 6, 2024 March 21, 2024 $1.40 $401 June 4, 2024 June 20, 2024 $1.40 $392 September 4, 2024 September 19, 2024 $1.40 $390 2023 March 8, 2023 March 23, 2023 $1.23 $368 June 7, 2023 June 22, 2023 $1.23 $362 September 6, 2023 September 21, 2023 $1.23 $362

Insurance and Contractholder _2

Insurance and Contractholder Liabilities (Tables)	9 Months Ended
	Sep. 30, 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: September 30, 2024 December 31, 2023 September 30, 2023 (In millions) Current Non-current Total Current Non-current Total Total Unpaid claims and claim expenses Cigna Healthcare $ 5,006 $ 82 $ 5,088 $ 5,017 $ 75 $ 5,092 $ 5,317 Other Operations 162 150 312 99 154 253 274 Future policy benefits Cigna Healthcare 89 510 599 97 518 615 590 Other Operations 157 3,301 3,458 163 3,375 3,538 3,380 Contractholder deposit funds Cigna Healthcare 10 120 130 12 133 145 151 Other Operations 364 5,982 6,346 362 6,178 6,540 6,607 Market risk benefits 30 914 944 37 966 1,003 934 Unearned premiums 710 31 741 846 22 868 1,385 Total 6,528 11,090 17,618 6,633 11,421 18,054 Insurance and contractholder liabilities classified as liabilities of businesses held for sale (1) (1,051) (517) (1,568) (1,119) (517) (1,636) Total insurance and contractholder liabilities $ 5,477 $ 10,573 $ 16,050 $ 5,514 $ 10,904 $ 16,418 $ 18,638 (1) Amounts classified as liabilities of businesses held for sale include $937 million of Unpaid claims, $422 million of Future policy benefits, $98 million of Unearned premiums and $111 million of Contractholder deposit funds as of September 30, 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: Nine Months Ended September 30, (In millions) 2024 (1) 2023 Beginning balance $ 5,092 $ 4,176 Less: Reinsurance and other amounts recoverable 236 221 Beginning balance, net 4,856 3,955 Incurred costs related to: Current year 28,314 26,788 Prior years (422) (237) Total incurred 27,892 26,551 Paid costs related to: Current year 23,761 22,053 Prior years 4,059 3,362 Total paid 27,820 25,415 Ending balance, net 4,928 5,091 Add: Reinsurance and other amounts recoverable 160 226 Ending balance $ 5,088 $ 5,317 (1) Includes unpaid claims amounts classified as liabilities of businesses held for sale. As of September 30, 2024 and December 31, 2023, $937 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: Nine Months Ended September 30, 2024 2023 (Dollars in millions) $ % (1) $ % (2) Actual completion factors and other $ 212 0.6 % $ 45 0.2 % Medical cost trend 210 0.6 192 0.6 Total favorable variance $ 422 1.2 % $ 237 0.8 % (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 September 30, 2024 September 30, 2023 Interest accretion rate 2.83 % 2.85 % Current discount rate 4.50 % 6.03 % Weighted average duration 9.0 years 7.0 years Nine Months Ended September 30, (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 assumptions 1,154 1,537 Effect of assumption changes and actual variances from expected experience (2) 3 314 Issuances and lapses 1,392 822 Net premiums collected (1,065) (1,019) Interest and other (3) 680 58 Ending balance at original discount rate 11,397 10,269 Effect of end of period discount rate assumptions (865) (1,681) Ending balance (4) $ 10,532 $ 8,588 Present value of expected policy benefits Beginning balance $ 9,633 $ 8,945 Reversal of effect of discount rate assumptions 1,220 1,611 Effect of assumption changes and actual variances from expected experience (2) 203 112 Issuances and lapses 1,316 902 Benefit payments (1,096) (1,017) Interest and other (3) 580 184 Ending balance at original discount rate 11,856 10,737 Effect of discount rate assumptions (926) (1,765) Ending balance (5) $ 10,930 $ 8,972 Liability for future policy benefits $ 398 $ 384 Other (6) 201 206 Total liability for future policy benefits (1)(7) $ 599 $ 590 (1) Includes $422 million and $429 million of future policy benefits classified as liabilities of businesses held for sale in the Consolidated Balance Sheets as of September 30, 2024 and December 31, 2023, respectively. (2) Includes the effect of actual variances from expectations, which decreased the total liability for future policy benefits by $(43) million and $(12) million, respectively, for the nine months ended September 30, 2024 and September 30, 2023. (3) 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. (4) As of September 30, 2024 and September 30, 2023, undiscounted expected future gross premiums were $20.7 billion and $18.5 billion, respectively. As of September 30, 2024 and September 30, 2023, discounted expected future gross premiums were $14.4 billion and $12.5 billion, respectively. (5) As of September 30, 2024 and September 30, 2023, undiscounted expected future policy benefits were $15.6 billion and $13.1 billion, respectively. (6) The liability for future policyholder benefits includes immaterial businesses shown as reconciling items above, most of which are in run-off. (7) $73 million and $154 million reported in Reinsurance recoverables in the Consolidated Balance Sheets as of September 30, 2024 and September 30, 2023, respectively, relate to the liability for future policy benefits. Additionally, $78 million of reinsurance recoverables are reported in assets of businesses held for sale in the Consolidated Balance Sheets as of September 30, 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 September 30, 2024 September 30, 2023 Interest accretion rate 5.64 % 5.64 % Current discount rate 4.81 % 5.73 % Weighted average duration 11.3 years 10.9 years
Summary of Market Risk Benefit	Market risk benefits activity was as follows: Nine Months Ended September 30, (Dollars in millions) 2024 2023 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 (7) (15) Changes due to capital markets versus expected (78) (352) Changes due to policyholder behavior versus expected (26) (1) Assumption changes 37 (16) Balance, end of period, before the effect of changes in nonperformance risk (own credit risk) 1,011 995 Nonperformance risk (own credit risk), end of period (67) (61) Balance, end of period $ 944 $ 934 Reinsured market risk benefit, end of period $ 1,008 $ 993 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 $3.0 billion remaining at September 30, 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) September 30, 2024 December 31, 2023 Collateral and Other Terms at September 30, 2024 Berkshire $ 836 $ 873 80% were secured by assets in a trust. Sun Life Assurance Company of Canada 75 92 Liberty Re (Bermuda) Ltd. 87 104 100% were secured by assets in a trust. SCOR SE 29 31 65% were secured by a letter of credit. Market risk benefits (2) $ 1,027 $ 1,100 (1) All reinsurers are rated A- equivalent and higher by an NRSRO. (2)
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) September 30, 2024 September 30, 2023 Net amount at risk $ 1,361 $ 1,986 Average attained age of contractholders (weighted by exposure) 77.6 years 75.9 years

Reinsurance (Tables)

Reinsurance (Tables)	9 Months Ended
	Sep. 30, 2024
Reinsurance Disclosures [Abstract]
Reinsurance Recoverables by Range of External Credit Rating and Collateral Level	The Company's reinsurance recoverables as of September 30, 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 collateral Total Ongoing Operations A- equivalent and higher current ratings (2) $ — $ 7 $ 235 $ 242 BBB- to BBB+ equivalent current credit ratings (2) — — 62 62 Not rated 143 11 3 157 Total recoverables related to ongoing operations 143 18 300 461 Acquisition, disposition or run-off activities BBB+ equivalent and higher current ratings (2) Lincoln National Life and Lincoln Life & Annuity of New York — 2,548 — 2,548 Empower Annuity Insurance Company — — 123 123 Prudential Insurance Company of America 320 — — 320 Life Insurance Company of North America — 311 — 311 Other 155 19 14 188 Not rated — 6 4 10 Total recoverables related to acquisition, disposition or run-off activities 475 2,884 141 3,500 Total reinsurance recoverables before market risk benefits $ 618 $ 2,902 $ 441 $ 3,961 Allowance for uncollectible reinsurance (30) Market risk benefits 1,008 Total reinsurance recoverables (3) $ 4,939 (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 $188 million of current reinsurance recoverables that are reported in Other current assets and $194 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: Nine Months Ended September 30, (Dollars in millions) 2024 2023 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 (7) (15) Changes due to capital markets versus expected (78) (352) Changes due to policyholder behavior versus expected (26) (1) Assumption changes 37 (16) Balance, end of period, before the effect of changes in nonperformance risk (own credit risk) 1,011 995 Nonperformance risk (own credit risk), end of period (67) (61) Balance, end of period $ 944 $ 934 Reinsured market risk benefit, end of period $ 1,008 $ 993 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 $3.0 billion remaining at September 30, 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) September 30, 2024 December 31, 2023 Collateral and Other Terms at September 30, 2024 Berkshire $ 836 $ 873 80% were secured by assets in a trust. Sun Life Assurance Company of Canada 75 92 Liberty Re (Bermuda) Ltd. 87 104 100% were secured by assets in a trust. SCOR SE 29 31 65% were secured by a letter of credit. Market risk benefits (2) $ 1,027 $ 1,100 (1) All reinsurers are rated A- equivalent and higher by an NRSRO. (2)

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 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: September 30, 2024 December 31, 2023 (In millions) Current Long-term Total Current Long-term Total Debt securities $ 596 $ 9,285 $ 9,881 $ 590 $ 9,265 $ 9,855 Equity securities 29 488 517 31 3,331 3,362 Commercial mortgage loans 165 1,295 1,460 182 1,351 1,533 Policy loans — 1,163 1,163 — 1,211 1,211 Other long-term investments — 4,545 4,545 — 4,181 4,181 Short-term investments 182 — 182 206 — 206 Total $ 972 $ 16,776 $ 17,748 $ 1,009 $ 19,339 $ 20,348 Investments classified as assets of businesses held for sale (1) (108) (1,506) (1,614) (84) (1,354) (1,438) Investments per Consolidated Balance Sheets $ 864 $ 15,270 $ 16,134 $ 925 $ 17,985 $ 18,910 (1)
Debt Securities by Contractual Maturity	The amortized cost and fair value by contractual maturity periods for debt securities were as follows as of September 30, 2024: (In millions) Amortized Fair Due in one year or less $ 784 $ 695 Due after one year through five years 3,897 3,806 Due after five years through ten years 3,117 3,033 Due after ten years 2,097 1,994 Mortgage and other asset-backed securities 378 353 Total $ 10,273 $ 9,881
Gross Unrealized Appreciation (Depreciation) on Debt Securities	Gross unrealized appreciation (depreciation) on debt securities by type of issuer is shown below: (In millions) Amortized Allowance for Credit Loss Unrealized Unrealized Fair September 30, 2024 Federal government and agency $ 273 $ — $ 21 $ (5) $ 289 State and local government 37 — 2 (1) 38 Foreign government 373 — 12 (9) 376 Corporate 9,212 (104) 204 (487) 8,825 Mortgage and other asset-backed 378 — 3 (28) 353 Total $ 10,273 $ (104) $ 242 $ (530) $ 9,881 December 31, 2023 Federal government and agency $ 251 $ — $ 24 $ (8) $ 267 State and local government 37 — 2 (1) 38 Foreign government 355 — 10 (13) 352 Corporate 9,338 (33) 158 (630) 8,833 Mortgage and other asset-backed 398 — 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. September 30, 2024 December 31, 2023 (Dollars in millions) Fair Amortized Unrealized Number Fair Amortized Unrealized Number One year or less Investment grade $ 202 $ 205 $ (3) 112 $ 330 $ 338 $ (8) 142 Below investment grade 91 100 (9) 155 161 170 (9) 135 More than one year Investment grade 5,076 5,543 (467) 1,382 5,441 6,036 (595) 1,590 Below investment grade 487 538 (51) 278 701 775 (74) 486 Total $ 5,856 $ 6,386 $ (530) 1,927 $ 6,633 $ 7,319 $ (686) 2,353
Equity Security Investments	The following table provides the values of the Company's equity security investments: September 30, 2024 December 31, 2023 (In millions) Cost Carrying Value Cost Carrying Value Equity securities with readily determinable fair values $ 657 $ 49 $ 656 $ 51 Equity securities with no readily determinable fair value 3,117 468 3,248 3,311 Total $ 3,774 $ 517 $ 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) September 30, 2024 December 31, 2023 Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Carrying Value Average Debt Service Coverage Ratio Average Loan-to-Value Ratio Below 60% $ 645 2.15 $ 802 2.13 60% to 79% 574 1.85 574 1.77 80% to 100% 241 0.92 157 0.65 Total $ 1,460 1.81 67 % $ 1,533 1.82 64 %
Carrying Value Information for 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 flow estimates 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) September 30, 2024 December 31, 2023 Real estate investments $ 1,760 $ 1,606 Securities partnerships 2,578 2,400 Other 207 175 Total $ 4,545 $ 4,181
Realized Gains and Losses on Investments	The following realized gains and losses on investments exclude realized gains and losses attributed to the Company's separate accounts because those gains and losses generally accrue directly to separate account policyholders: Three Months Ended September 30, Nine Months Ended September 30, (In millions) 2024 2023 2024 2023 Net realized investment gains (losses), excluding credit (loss)/recovery and other investment write-downs $ 25 $ (9) $ 32 $ (29) Credit (loss)/recovery and other investment write-downs (946) (5) (2,837) (15) Net realized investment (losses), before income taxes $ (921) $ (14) $ (2,805) $ (44)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 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 Significant Other Observable Inputs Significant Unobservable Inputs Total September 30, December 31, 2023 September 30, December 31, 2023 September 30, December 31, 2023 September 30, December 31, 2023 Financial assets at fair value Debt securities Federal government and agency $ 168 $ 130 $ 121 $ 137 $ — $ — $ 289 $ 267 State and local government — — 38 38 — — 38 38 Foreign government — — 376 352 — — 376 352 Corporate — — 8,448 8,432 377 401 8,825 8,833 Mortgage and other asset-backed — — 307 319 46 46 353 365 Total debt securities 168 130 9,290 9,278 423 447 9,881 9,855 Equity securities (1) 1 4 48 47 — — 49 51 Short-term investments — — 182 206 — — 182 206 Derivative assets — — 129 131 — 1 129 132 Financial liabilities at fair value Derivative liabilities $ — $ — $ 5 $ 4 $ — $ — $ 5 $ 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 of Unobservable Adjustment Range (Weighted Average by Quantity) as of (Fair value in millions) September 30, 2024 December 31, 2023 Unobservable Input September 30, 2024 September 30, 2024 December 31, 2023 Debt securities Corporate $ 377 $ 401 Liquidity 60 - 1495 (380) bps 70 - 1235 (310) bps Mortgage and other asset-backed securities 46 46 Liquidity 100 - 635 (320) bps 95 - 640 (310) bps Total Level 3 debt securities $ 423 $ 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 September 30, Nine Months Ended (In millions) 2024 2023 2024 2023 Debt and Equity Securities Beginning balance $ 397 $ 454 $ 447 $ 447 Losses included in Shareholders' net income (10) (1) (71) (1) Gains (losses) included in Other comprehensive income (loss) 8 (5) 3 (5) Purchases, sales and settlements Purchases 4 6 15 10 Sales (2) — (2) — Settlements (4) (5) (19) (32) Total purchases, sales and settlements (2) 1 (6) (22) Transfers into / (out of) Level 3 Transfers into Level 3 32 — 63 71 Transfers out of Level 3 (2) (13) (13) (54) Total transfers into / (out of) Level 3 30 (13) 50 17 Ending balance $ 423 $ 436 $ 423 $ 436 Total losses included in Shareholders' net income attributable to instruments held at the reporting date $ (9) $ (1) $ (71) $ (1) Change in unrealized gain or (loss) included in Other comprehensive income (loss) for assets held at the end of the reporting period $ 8 $ (4) $ 3 $ (9)
Fair Values of Separate Account Assets	Fair values of Separate account assets were as follows: Quoted Prices in Active Markets for Identical Assets Significant Other Observable Inputs Significant Unobservable Inputs Total (In millions) September 30, 2024 December 31, 2023 September 30, 2024 December 31, 2023 September 30, 2024 December 31, 2023 September 30, 2024 December 31, 2023 Guaranteed separate accounts (See Note 16) $ 247 $ 226 $ 353 $ 352 $ — $ — $ 600 $ 578 Non-guaranteed separate accounts (1) 166 158 6,007 5,797 227 217 6,400 6,172 Subtotal $ 413 $ 384 $ 6,360 $ 6,149 $ 227 $ 217 7,000 6,750 Non-guaranteed separate accounts priced at net asset value ("NAV") as a practical expedient (1) 651 680 Total $ 7,651 $ 7,430 (1) Non-guaranteed separate accounts include $4.0 billion as of both September 30, 2024 and December 31, 2023 in assets supporting the Company's pension plans, including $0.2 billion classified in Level 3 as of both September 30, 2024 and December 31, 2023.
Additional Information on Separate Account Assets Priced at NAV	Separate account investments in securities partnerships, real estate, real estate funds 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 of Unfunded Commitment as of September 30, 2024 Redemption Frequency Redemption Notice (In millions) September 30, 2024 December 31, 2023 Securities partnerships $ 413 $ 419 $ 224 Not applicable Not applicable Real estate and real estate funds 237 258 3 Quarterly 30 - 90 days Hedge funds 1 3 — Up to annually, varying by fund 30 - 90 days Total $ 651 $ 680 $ 227
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 Hierarchy September 30, 2024 December 31, 2023 (In millions) Fair Value Carrying Value Fair Value Carrying Value Commercial mortgage loans Level 3 $ 1,394 $ 1,460 $ 1,430 $ 1,533 Long-term debt, including current maturities, excluding finance leases Level 2 $ 29,854 $ 31,073 $ 28,033 $ 29,585

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 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 Nine Months Ended (In millions) 2024 2023 2024 2023 Securities and Derivatives Beginning balance $ 400 $ (118) $ 171 $ (332) Unrealized appreciation (depreciation) on securities and derivatives 319 (257) 568 2 Tax (expense) benefit (65) 57 (133) (9) Net unrealized appreciation (depreciation) on securities and derivatives 254 (200) 435 (7) Reclassification adjustment for losses included in Shareholders' net income (Net realized investment losses) 12 12 73 38 Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses) — (1) — (1) Reclassification adjustment for tax (benefit) included in Shareholders' net income (2) (3) (15) (8) Net losses reclassified from AOCI to Shareholders' net income 10 8 58 29 Other comprehensive income (loss), net of tax 264 (192) 493 22 Ending balance $ 664 $ (310) $ 664 $ (310) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Net long-duration insurance and contractholder liabilities measurement adjustments Beginning balance $ (1,743) $ (704) $ (971) $ (256) Current period change in discount rate for certain long-duration liabilities (34) (27) (1,054) (585) Tax benefit 3 12 265 149 Net current period change in discount rate for certain long-duration liabilities (31) (15) (789) (436) Current period change in instrument-specific credit risk for market risk benefits 3 (17) (15) (50) Tax benefit — 4 4 10 Net current period change in instrument-specific credit risk for market risk benefits 3 (13) (11) (40) Other comprehensive (loss), net of tax (28) (28) (800) (476) Ending balance $ (1,771) $ (732) $ (1,771) $ (732) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Translation of foreign currencies Beginning balance $ (180) $ (157) $ (149) $ (154) Translation of foreign currencies 41 (31) 13 (36) Tax (expense) benefit (2) 2 (5) 4 Other comprehensive income (loss), net of tax 39 (29) 8 (32) Ending balance $ (141) $ (186) $ (141) $ (186) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Postretirement benefits liability Beginning balance $ (919) $ (899) $ (915) $ (916) Reclassification adjustment for amortization of net prior actuarial losses and prior service costs (Interest expense and other) 9 11 24 35 Reclassification adjustment for tax (benefit) included in Shareholders' net income (5) (3) (8) (9) Net adjustments reclassified from AOCI to Shareholders' net income 4 8 16 26 Valuation update (1) — (21) (2) Tax benefit 1 — 5 1 Net change due to valuation update — — (16) (1) Other comprehensive income, net of tax 4 8 — 25 Ending balance $ (915) $ (891) $ (915) $ (891) Three Months Ended Nine Months Ended (In millions) 2024 2023 2024 2023 Total Accumulated other comprehensive loss Beginning balance $ (2,442) $ (1,878) $ (1,864) $ (1,658) Shareholders' other comprehensive income (loss), net of tax 279 (241) (299) (461) Ending balance $ (2,163) $ (2,119) $ (2,163) $ (2,119)

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 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 September 30, Nine Months Ended September 30, 2024 2023 2024 2023 (In millions) Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Pre-tax After-tax Impairment of dividend receivable $ 182 $ 138 $ — $ — $ 182 $ 138 $ — $ — Integration and transaction-related costs 77 59 13 9 177 135 20 15 Loss on sale of businesses 87 62 21 19 106 19 21 19 Deferred tax expenses, net — 41 — — — 75 — — Charges associated with litigation matters — — 201 171 — — 201 171 Total impact from special items $ 346 $ 300 $ 235 $ 199 $ 465 $ 367 $ 242 $ 205
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 September 30, 2024 Revenues from external customers $ 51,552 $ 11,919 $ 137 $ 1 $ 63,609 Intersegment revenues 1,045 1,279 18 (2,342) Net investment (loss) income (142) 142 79 6 85 Total revenues 52,455 13,340 234 (2,335) 63,694 Net realized investment results from certain equity method investments — (177) — — (177) Special item related to impairment of dividend receivable 182 — — — 182 Adjusted revenues $ 52,637 $ 13,163 $ 234 $ (2,335) $ 63,699 Income (loss) before income taxes $ 631 $ 1,073 $ (10) $ (502) $ 1,192 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (99) — — — (99) Net realized investment losses (gains) (1) 748 (8) 4 — 744 Amortization of acquired intangible assets 414 22 — — 436 Special items Impairment of dividend receivable 182 — — — 182 Integration and transaction-related costs — — — 77 77 Loss on sale of businesses — 87 — — 87 Pre-tax adjusted income (loss) from operations $ 1,876 $ 1,174 $ (6) $ (425) $ 2,619 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Three months ended September 30, 2023 Revenues from external customers $ 37,230 $ 11,426 $ 71 $ — $ 48,727 Intersegment revenues 1,303 1,136 — (2,439) Net investment income 63 176 76 6 321 Total revenues 38,596 12,738 147 (2,433) 49,048 Net realized investment results from certain equity method investments — 30 — — 30 Adjusted revenues $ 38,596 $ 12,768 $ 147 $ (2,433) $ 49,078 Income (loss) before income taxes $ 1,272 $ 1,019 $ (3) $ (448) $ 1,840 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (44) — — — (44) Net realized investment losses (1) 1 35 8 — 44 Amortization of acquired intangible assets 443 11 — — 454 Special items Integration and transaction-related costs — — — 13 13 Loss on sale of businesses — — 21 — 21 Charges associated with litigation matters 44 157 — — 201 Pre-tax adjusted income (loss) from operations $ 1,716 $ 1,222 $ 26 $ (435) $ 2,529 (1) Includes Net realized investment losses/gains 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. (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Nine months ended September 30, 2024 Revenues from external customers $ 144,689 $ 35,752 $ 333 $ 2 $ 180,776 Intersegment revenues 3,558 3,606 63 (7,227) Net investment (loss) income (18) 463 231 20 696 Total revenues 148,229 39,821 627 (7,205) 181,472 Net realized investment results from certain equity method investments — (238) — — (238) Special item related to impairment of dividend receivable 182 — — — 182 Adjusted revenues $ 148,411 $ 39,583 $ 627 $ (7,205) $ 181,416 Income (loss) before income taxes $ 1,494 $ 3,221 $ (9) $ (1,446) $ 3,260 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (271) — — — (271) Net realized investment losses (1) 2,203 359 5 — 2,567 Amortization of acquired intangible assets 1,247 32 — — 1,279 Special items Impairment of dividend receivable 182 — — — 182 Integration and transaction-related costs — — — 177 177 Loss on sale of businesses — 106 — — 106 Pre-tax adjusted income (loss) from operations $ 4,855 $ 3,718 $ (4) $ (1,269) $ 7,300 (In millions) Evernorth Health Services Cigna Healthcare Other Operations Corporate and Eliminations Total Nine months ended September 30, 2023 Revenues from external customers $ 108,462 $ 34,581 $ 232 $ — $ 143,275 Intersegment revenues 4,343 3,143 — (7,486) Net investment income 175 454 230 17 876 Total revenues 112,980 38,178 462 (7,469) 144,151 Net realized investment results from certain equity method investments — 22 — — 22 Adjusted revenues $ 112,980 $ 38,200 $ 462 $ (7,469) $ 144,173 Income (loss) before income taxes $ 3,318 $ 3,252 $ 47 $ (1,292) $ 5,325 Pre-tax adjustments to reconcile to adjusted income from operations (Income) attributable to noncontrolling interests (140) (2) — — (142) Net realized investment losses (1) — 64 2 — 66 Amortization of acquired intangible assets 1,330 38 — — 1,368 Special items Integration and transaction-related costs — — — 20 20 Loss on sale of businesses — — 21 — 21 Charges associated with litigation matters 44 157 — — 201 Pre-tax adjusted income (loss) from operations $ 4,552 $ 3,509 $ 70 $ (1,272) $ 6,859 (1)
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 September 30, Nine Months Ended September 30, (In millions) 2024 2023 2024 2023 Products (Pharmacy revenues) (ASC 606) Network revenues $ 27,353 $ 16,926 $ 76,795 $ 49,080 Home delivery and specialty revenues 18,909 16,324 53,384 48,943 Other revenues 2,990 2,390 8,433 6,506 Total Evernorth Health Services 49,252 35,640 138,612 104,529 Total Other Operations 14 — 47 — Intercompany eliminations (982) (1,109) (3,238) (3,890) Total Pharmacy revenues 48,284 34,531 135,421 100,639 Insurance premiums (ASC 944) Cigna Healthcare (1) U.S. Healthcare Employer insured 4,382 4,144 13,125 12,315 Medicare Advantage 2,110 2,189 6,604 6,605 Stop loss 1,689 1,548 5,022 4,565 Individual and Family Plans 1,001 1,269 3,016 3,770 Other 1,203 927 3,681 3,091 U.S. Healthcare 10,385 10,077 31,448 30,346 International Health 911 834 2,687 2,440 Total Cigna Healthcare 11,296 10,911 34,135 32,786 Other 122 70 285 225 Intercompany eliminations 18 17 73 51 Total Premiums 11,436 10,998 34,493 33,062 Services (Fees) (ASC 606) Evernorth Health Services 3,314 2,862 9,508 8,199 Cigna Healthcare 1,671 1,639 4,850 4,847 Other Operations 15 1 57 3 Other revenues 267 43 509 172 Intercompany eliminations (1,378) (1,347) (4,062) (3,647) Total Fees and other revenues 3,889 3,198 10,862 9,574 Total revenues from external customers $ 63,609 $ 48,727 $ 180,776 $ 143,275 (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 and nine months ended September 30, 2023 has been restated to conform to the new operating segment presentation.

Description of Business (Detail

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

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Details) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2024	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Decrease to shareholders' equity	$ (42,298)	$ (45,702)	$ (42,298)	$ (45,702)	$ (41,527)	$ (46,244)	$ (45,464)	$ (44,688)
Increase to shareholders' net income	$ 739	$ 1,408	$ 2,010	$ 4,135
Increase to diluted earnings per share (in dollars per share)	$ 2.63	$ 4.74	$ 7.05	$ 13.89

Accounts Receivable, Net - Amou

Accounts Receivable, Net - Amounts Included in Accounts Receivable, Net (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Accounts, Notes, Loans and Financing Receivable [Line Items]
Pharmaceutical manufacturers receivable, including held for sale assets	$ 13,708	$ 8,169
Noninsurance customer receivables, including held for sale assets	12,615	8,044
Insurance customer receivables, including held for sale assets	2,732	2,359
Other receivables, including held for sale assets	323	272
Total	29,378	18,844
Accounts receivable, net	27,846	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	$ (1,532)	$ (1,122)

Accounts Receivable, Net - Narr

Accounts Receivable, Net - Narrative (Details) - USD ($)	1 Months Ended	3 Months Ended		9 Months Ended
	Jul. 31, 2023	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Receivables [Abstract]
Allowance for receivables, current		$ 4,600,000,000		$ 4,600,000,000		$ 3,700,000,000
Allowance for current expected credit losses on accounts receivable		88,000,000		88,000,000		90,000,000
Total capacity, uncommitted factoring facility	$ 1,000,000,000	1,500,000,000		1,500,000,000
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		1,300,000,000	$ 1,000,000,000	4,500,000,000	$ 1,000,000,000
Accounts receivable sold that remain outstanding, uncommitted factoring facility		258,000,000		258,000,000		0
Accounts receivable received but not remitted, uncommitted factoring facility		$ 1,100,000,000		$ 1,100,000,000		$ 515,000,000

Supplier Finance Program (Detai

Supplier Finance Program (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Outstanding payment obligations, current	$ 1,600	$ 1,500
Supplier Finance Program, Obligation, Current, Statement of Financial Position [Extensible Enumeration]	Accounts payable	Accounts payable
Outstanding payment obligations, current, voluntarily elected by suppliers to be sold to the financial institution	$ 534

Assets and Liabilities of Bus_3

Assets and Liabilities of Businesses Held for Sale (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jan. 31, 2024	Dec. 31, 2023
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax [Abstract]
Integration and transaction-related costs	$ 77	$ 13	$ 177	$ 20
Integration and transaction-related costs, after-tax	59	$ 9	135	$ 15
Medicare Advantage and related Cigna Healthcare businesses | Held-for-Sale
Disposal Group, Including Discontinued Operation, Balance Sheet Disclosures [Abstract]
Cash and cash equivalents	1,249		1,249			$ 467
Investments	1,614		1,614			1,438
Accounts receivable, net	1,532		1,532			1,122
Other assets, including Goodwill	2,479		2,479			2,963
Goodwill classified as Assets of businesses held for sale	396		396			396
Total assets of businesses held for sale	6,874		6,874			5,990
Insurance and contractholder liabilities	1,568		1,568			1,636
All other liabilities	1,207		1,207			1,059
Total liabilities of businesses held for sale	$ 2,775		$ 2,775			$ 2,695
Medicare Advantage and related Cigna Healthcare businesses | Held-for-Sale | Health Care Service Corporation (HCSC)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale price					$ 3,300

Earnings Per Share - Computatio

Earnings Per Share - Computation of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Shareholders' net income	$ 739	$ 1,408	$ 2,010	$ 4,135
Shares:
Weighted average	278,457	294,058	282,005	294,752
Common stock equivalents	2,939	3,073	3,037	2,911
Total shares	281,396	297,131	285,042	297,663
Earnings per share, basic	$ 2.65	$ 4.79	$ 7.13	$ 14.03
Earnings per share, effect of dilution	(0.02)	(0.05)	(0.08)	(0.14)
Earnings per share, diluted	$ 2.63	$ 4.74	$ 7.05	$ 13.89

Earnings Per Share - Outstandin

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		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Employee Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive options	0.8	0.9	1	0.9

Earnings Per Share - Shares of

Earnings Per Share - Shares of Common Stock Held in Treasury (Details) - shares shares in Millions	Sep. 30, 2024	Dec. 31, 2023	Sep. 30, 2023
Earnings Per Share [Abstract]
Shares of common stock held in treasury	122.5	107.4	105.7

Debt - Outstanding Amounts of D

Debt - Outstanding Amounts of Debt and Finance Leases (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
Short-term debt
Commercial paper	$ 1,635,000,000	$ 1,237,000,000
Other, including finance leases	44,000,000	42,000,000
Total short-term debt	2,572,000,000	2,775,000,000
Long-term debt
Other, including finance leases	50,000,000	66,000,000
Total long-term debt	30,230,000,000	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 (1)
Short-term debt
Current maturities	$ 0	996,000,000
Long-term debt
Gross value	$ 790,000,000
Interest Rate	3.50%
$900 million, 3.250% Notes due April 2025 (2)
Short-term debt
Current maturities	$ 893,000,000	0
Long-term debt
Long-term debt	0	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	$ 1,215,000,000	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	$ 1,462,000,000	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	$ 3,789,000,000	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%
$1,400 million, 2.400% Notes due March 2030 (1) (2)
Long-term debt
Long-term debt	$ 1,405,000,000	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	$ 1,411,000,000	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
Long-term debt
Long-term debt	$ 45,000,000	45,000,000
Gross value	$ 45,000,000
Interest Rate	8.08%
$800 million, 5.400% Notes due March 2033
Long-term debt
Long-term debt	$ 795,000,000	794,000,000
Gross value	$ 800,000,000
Interest Rate	5.40%
$1,250 million, 5.250% Notes due February 2034 (2)
Long-term debt
Long-term debt	$ 1,256,000,000	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	$ 486,000,000	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	$ 1,468,000,000	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	$ 990,000,000	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	$ 2,971,000,000	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%

Debt - Short-term and Credit Fa

Debt - Short-term and Credit Facilities Debt (Details)	1 Months Ended	9 Months Ended
	Apr. 30, 2024 USD ($) revolvingCreditFacility commercialBank	Sep. 30, 2024 USD ($)	Jun. 30, 2024 USD ($)
Debt Instrument [Line Items]
Commercial paper average interest rate		5.33%
Commercial Paper
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 6,500,000,000	$ 5,000,000,000
Revolving Credit Agreements, April 2024
Debt Instrument [Line Items]
Outstanding balances		$ 0
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 | commercialBank	22
Leverage ratio covenant	60%
Five-year Revolving Credit Agreement, Maturing April 2029
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
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 500,000,000
364-day Revolving Credit Agreement, Maturing April 2025
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

Debt - Long-term Debt (Details)

Debt - Long-term Debt (Details)	1 Months Ended	9 Months Ended
	Feb. 29, 2024 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Mar. 31, 2024 USD ($)
Debt Instrument [Line Items]
Aggregate principal amount of outstanding debt securities redeemed				$ 1,800,000,000
Repayment of long-term debt		$ 3,000,000,000	$ 2,967,000,000
Senior Notes
Debt Instrument [Line Items]
Principal	$ 4,500,000,000
$1,000 million, 5.000% Notes due May 2029
Debt Instrument [Line Items]
Interest rate		5%
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%
Net proceeds	$ 995,000,000
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
Redemption price discount, spread on variable rate	0.0015
$1,250 million, 5.250% Notes due February 2034 (2)
Debt Instrument [Line Items]
Interest rate		5.25%
Gross value		$ 1,250,000,000
$1,250 million, 5.250% Notes due February 2034 (2) | Senior Notes
Debt Instrument [Line Items]
Principal	$ 1,250,000,000
Interest rate	5.25%
Net proceeds	$ 1,244,000,000
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
Redemption price discount, spread on variable rate	0.0020

Debt - Interest Expense (Detail

Debt - Interest Expense (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Debt Disclosure [Abstract]
Interest expense on long-term and short-term debt	$ 380	$ 353	$ 1,100	$ 1,000

Common and Preferred Stock - Di

Common and Preferred Stock - Dividends (Details) - USD ($) $ / shares in Units, $ in Millions								3 Months Ended		9 Months Ended
	Oct. 23, 2024	Sep. 19, 2024	Jun. 20, 2024	Mar. 21, 2024	Sep. 21, 2023	Jun. 22, 2023	Mar. 23, 2023	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Equity [Abstract]
Amount per share (in dollars per share)		$ 1.40	$ 1.40	$ 1.40	$ 1.23	$ 1.23	$ 1.23
Total amount paid		$ 390	$ 392	$ 401	$ 362	$ 362	$ 368			$ 1,183	$ 1,092
Subsequent Event [Line Items]
Common dividends declared (in dollars per share)								$ 1.40	$ 1.23	$ 4.20	$ 3.69
Subsequent Event
Subsequent Event [Line Items]
Common dividends declared (in dollars per share)	$ 1.40

Common and Preferred Stock - Ac

Common and Preferred Stock - Accelerated Share Repurchase Agreements (Details) - USD ($) $ / shares in Units, shares in Millions	3 Months Ended		8 Months Ended	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2024	Sep. 30, 2023	Feb. 15, 2024
Accelerated Share Repurchases [Line Items]
Shares repurchased, value	$ 0	$ 681,000,000		$ 5,057,000,000	$ 1,785,000,000
Treasury Stock
Accelerated Share Repurchases [Line Items]
Shares repurchased, value	0	681,000,000		5,057,000,000	1,785,000,000
Additional Paid-in Capital
Accelerated Share Repurchases [Line Items]
Shares repurchased, value	$ 0	$ 0		$ 0	$ 0
Accelerated Share Repurchase Agreement, February 2024
Accelerated Share Repurchases [Line Items]
Accelerated stock repurchase, amount authorized						$ 3,200,000,000
Shares repurchased			9.3
Shares repurchased, cost per share			$ 344.98

Insurance and Contractholder _3

Insurance and Contractholder Liabilities - Account Balances (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023	Sep. 30, 2023	Dec. 31, 2022
Current
Market risk benefits, current	$ 30	$ 37
Unearned premiums, current, including held for sale liabilities	710	846
Total, current	6,528	6,633
Current insurance and contractholder liabilities	5,477	5,514
Non-current
Market risk benefits, non-current	914	966
Unearned premiums, non-current, including held for sale liabilities	31	22
Total, non-current	11,090	11,421
Non-current insurance and contractholder liabilities	10,573	10,904
Total
Market risk benefits	944	1,003	$ 934
Unearned premiums			1,385
Unearned premiums, including held for sale liabilities	741	868
Total	17,618	18,054
Total insurance and contractholder liabilities	16,050	16,418	18,638
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Current
Insurance and contractholder liabilities current, classified as held for sale	(1,051)	(1,119)
Non-current
Insurance and contractholder liabilities, non-current, classified as held for sale	(517)	(517)
Total
Insurance and contractholder liabilities classified as held for sale	(1,568)	(1,636)
Unpaid claims classified as liabilities of business held for sale	937	823
Unearned premiums classified as liabilities of business held for sale	98	261
Contractholder deposit funds classified as liabilities held for sale	111	123
Cigna Healthcare
Current
Unpaid claims and claim expenses, current, including held for sale liabilities	5,006	5,017
Future policy benefits, current, including held for sale liabilities	89	97
Contractholder deposit funds, current, including held for sale liabilities	10	12
Non-current
Unpaid claims and claim expenses, non-current, including held for sale liabilities	82	75
Future policy benefits, non-current, including held for sale liabilities	510	518
Contractholder deposit funds, non-current, including liabilities held for sale	120	133
Total
Unpaid claims and claim expenses			5,317	$ 4,176
Unpaid claims and claim expenses, including held for sale liabilities	5,088	5,092
Total liability for future policy benefits			590
Future policy benefits, including held for sale liabilities	599	615
Contractholder deposit funds			151
Contractholder deposit funds, including liabilities held for sale	130	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	422	429
Other Operations
Current
Unpaid claims and claim expenses, current	162	99
Future policy benefits, current	157	163
Contractholder deposit funds, current	364	362
Non-current
Unpaid claims and claim expenses, non-current	150	154
Future policy benefits, non-current	3,301	3,375
Contractholder deposit funds, non-current	5,982	6,178
Total
Unpaid claims and claim expenses	312	253	274
Total liability for future policy benefits	3,458	3,538	3,380
Contractholder deposit funds	$ 6,346	$ 6,540	$ 6,607	$ 6,700

Insurance and Contractholder _4

Insurance and Contractholder Liabilities - Unpaid Claims and Claim Expenses - Cigna Healthcare - Activity (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 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	$ 937		$ 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 and reported claims in process	4,700	$ 5,000
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	28,314	26,788
Prior years	(422)	(237)
Total incurred	27,892	26,551
Paid costs related to:
Current year	23,761	22,053
Prior years	4,059	3,362
Total paid	27,820	25,415
Ending balance, net		5,091
Add: Reinsurance and other amounts recoverable		226
Ending balance		$ 5,317
Ending balance, net, including held for sale liabilities	4,928
Add: Reinsurance, including held for sale liabilities	160
Ending balance, including held for sale liabilities	$ 5,088

Insurance and Contractholder _5

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	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 422	$ 237
Favorable (unfavorable) variance, percentage	1.20%	0.80%
Actual completion factors and other
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 212	$ 45
Favorable (unfavorable) variance, percentage	0.60%	0.20%
Medical cost trend
Causes of Increase (Decrease) in Liability for Unpaid Claims and Claims Adjustment Expense [Abstract]
Favorable (unfavorable) variance, amount	$ 210	$ 192
Favorable (unfavorable) variance, percentage	0.60%	0.60%

Insurance and Contractholder _6

Insurance and Contractholder Liabilities - Future Policy Benefits - Interest Rates and Duration (Details)	Sep. 30, 2024	Sep. 30, 2023
Cigna Healthcare
Insurance and Contractholder Liabilities [Line Items]
Interest accretion rate	2.83%	2.85%
Current discount rate	4.50%	6.03%
Weighted average duration	9 years	7 years
Other Operations
Insurance and Contractholder Liabilities [Line Items]
Interest accretion rate	5.64%	5.64%
Current discount rate	4.81%	5.73%
Weighted average duration	11 years 3 months 18 days	10 years 10 months 24 days

Insurance and Contractholder _7

Insurance and Contractholder Liabilities - Future Policy Benefits - Present Values of Expected Premiums and Benefits (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023	Dec. 31, 2022
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
Effect of assumption changes and actual variances from expected experience			$ 3	$ 314
Issuances and lapses	1,392	822
Net premiums collected	(1,065)	(1,019)
Interest and other	680	58
Ending balance at original discount rate	11,397	10,269
Effect of end of period discount rate assumptions	(865)	(1,681)
Ending balance	10,532	8,588	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
Effect of assumption changes and actual variances from expected experience (2)			203	112
Issuances and lapses	1,316	902
Benefit payments	(1,096)	(1,017)
Interest and other	580	184
Ending balance at original discount rate	11,856	10,737
Effect of discount rate assumptions	(926)	(1,765)
Ending balance	10,930	8,972	9,633	8,945
Liability for future policy benefits	398	384
Other	201	206
Total liability for future policy benefits		590
Total liability for future policy benefits, including assets held for sale	599
Effect of actual variances from expectations	(43)	(12)
Undiscounted expected future gross premiums	20,700	18,500
Discounted expected future gross premiums	14,400	12,500
Undiscounted expected future policy benefits	15,600	13,100
Future policy benefits reserve, reinsurance recoverables	73	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 classified as liabilities of business held for sale	422		429
Future policy benefits reserve, reinsurance recoverables reported in assets of businesses held for sale	78
Other Operations
Liability for Future Policy Benefit, Expected Future Policy Benefit [Roll Forward]
Total liability for future policy benefits	3,458	3,380	3,538
Undiscounted expected future policy benefits	4,300	4,500
Future policy benefits reserve, reinsurance recoverables	900	1,000
Deferred profit liability included in future policy benefits	400	400
Future policy benefit, excluding deferred profit liability	$ 3,100	$ 3,000	$ 3,200	$ 3,200

Insurance and Contractholder _8

Insurance and Contractholder Liabilities - Contractholder Deposit Funds (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023	Sep. 30, 2023	Dec. 31, 2022
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit fund liabilities, approximate percent reinsured externally	38%
Cigna Healthcare
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds			$ 151
Other Operations
Insurance and Contractholder Liabilities [Line Items]
Contractholder deposit funds	$ 6,346	$ 6,540	$ 6,607	$ 6,700
Weighted average crediting rate	3.33%		3.27%
Net amount at risk	$ 2,900		$ 3,100
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%		99%
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	1,100		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	$ 1,700		$ 1,700
Percentage with cash values at more than 110% of guaranteed cash value	90%		90%
Other Operations | Minimum | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150
Insurance and Contractholder Liabilities [Line Items]
Basis points 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%		3%
Other Operations | Maximum | Policyholder Account Balance, above Guaranteed Minimum Crediting Rate, Range from 0051 to 0150
Insurance and Contractholder Liabilities [Line Items]
Basis points 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%		4%

Insurance and Contractholder _9

Insurance and Contractholder Liabilities - Market Risk Benefits (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 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	(7)	(15)
Changes due to capital markets versus expected	(78)	(352)
Changes due to policyholder behavior versus expected	(26)	(1)
Assumption changes	37	(16)
Balance, end of period, before the effect of changes in nonperformance risk (own credit risk)	1,011	995
Nonperformance risk (own credit risk), end of period	(67)	(61)
Balance, end of period	944	934
Reinsured market risk benefit, end of period	$ 1,008	$ 993

Insurance and Contractholder_10

Insurance and Contractholder Liabilities - Net Amount of Risk and Average Age of Contractholders (Details) - Variable Annuity - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Net Amount at Risk by Product and Guarantee [Line Items]
Net amount at risk	$ 1,361	$ 1,986
Average attained age of contractholders (weighted by exposure)	77 years 7 months 6 days	75 years 10 months 24 days

Reinsurance - Reinsurance Recov

Reinsurance - Reinsurance Recoverables (Details) - USD ($) $ in Millions	Sep. 30, 2024	Sep. 30, 2023
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	$ 3,961
Allowance for uncollectible reinsurance, including assets held for sale	(30)
Market risk benefits	1,008	$ 993
Total reinsurance recoverables, including assets held for sale	4,939
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	194
Other Current Assets
Ceded Credit Risk [Line Items]
Reinsurance recoverables	188
Berkshire Hathway Life Insurance Company Of Nebraska and Other Recoverables
Ceded Credit Risk [Line Items]
Market risk benefits	1,008
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	618
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	2,902
No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	441
Ongoing Operations
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	461
Ongoing Operations | A- equivalent and higher current ratings
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	242
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	62
Ongoing Operations | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	157
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	143
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	143
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	18
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	7
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	11
Ongoing Operations | No collateral
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	300
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	235
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	62
Ongoing Operations | No collateral | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	3
Acquisition, disposition or run-off activities
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	3,500
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	2,548
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	123
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	320
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	311
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	188
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	475
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	320
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	155
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	2,884
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	2,548
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	311
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | BBB+ equivalent and higher current ratings | Other
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	19
Acquisition, disposition or run-off activities | Collateral provisions exist that may mitigate risk of credit loss | Not rated
Ceded Credit Risk [Line Items]
Reinsurance recoverables before market risk benefits, including assets held for sale	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	141
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	123
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

Reinsurance - Effective Exit of

Reinsurance - Effective Exit of Variable Annuity Reinsurance Business (Details) - Variable Annuity - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 1,027		$ 1,027		$ 1,100
Incurred but not yet paid and outstanding claims	19		19		19
Impact of non-performance risk
Berkshire
Ceded Credit Risk [Line Items]
Percent of future claim payments reinsured	100%		100%
Remaining overall limit under reinsurance agreement	$ 3,000		$ 3,000
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	836		$ 836		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			80%
Sun Life Assurance Company of Canada
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	75		$ 75		92
Liberty Re (Bermuda) Ltd.
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	87		$ 87		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%
SCOR SE
Ceded Credit Risk [Line Items]
Market risk benefits reinsurance recoverable, including IBNR and outstanding claims, less premiums due	$ 29		$ 29		$ 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			65%

Investments - Investments by Ca

Investments - Investments by Category (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Current
Investments including held for sale assets	$ 972	$ 1,009
Current investments	864	925
Long-term
Investments including held for sale assets	16,776	19,339
Investments per Consolidated Balance Sheets	15,270	17,985
Total
Investments including held for sale assets	17,748	20,348
Total investments	16,134	18,910
Held-for-Sale | Medicare Advantage and related Cigna Healthcare businesses
Current
Investments classified as assets of business held for sale	(108)	(84)
Long-term
Investments classified as assets of business held for sale	(1,506)	(1,354)
Total
Investments classified as assets of business held for sale	(1,614)	(1,438)
Debt securities
Current
Investments including held for sale assets	596	590
Long-term
Investments including held for sale assets	9,285	9,265
Total
Investments including held for sale assets	9,881	9,855
Equity securities
Current
Investments including held for sale assets	29	31
Long-term
Investments including held for sale assets	488	3,331
Total
Investments including held for sale assets	517	3,362
Commercial mortgage loans
Current
Investments including held for sale assets	165	182
Long-term
Investments including held for sale assets	1,295	1,351
Total
Investments including held for sale assets	1,460	1,533
Policy loans
Current
Investments including held for sale assets	0	0
Long-term
Investments including held for sale assets	1,163	1,211
Total
Investments including held for sale assets	1,163	1,211
Other long-term investments
Current
Investments including held for sale assets	0	0
Long-term
Investments including held for sale assets	4,545	4,181
Total
Investments including held for sale assets	4,545	4,181
Short-term investments
Current
Investments including held for sale assets	182	206
Long-term
Investments including held for sale assets	0	0
Total
Investments including held for sale assets	$ 182	$ 206

Investments - Debt Securities b

Investments - Debt Securities by Contractual Maturity Periods (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Amortized Cost
Due in one year or less, including assets held for sale	$ 784
Due after one year through five years, including assets held for sale	3,897
Due after five years through ten years, including assets held for sale	3,117
Due after ten years, including assets held for sale	2,097
Mortgage and other asset-backed securities, including assets held for sale	378
Total, including assets held for sale	10,273	$ 10,379
Fair Value
Due in one year or less, including assets held for sale	695
Due after one year through five years, including assets held for sale	3,806
Due after five years through ten years, including assets held for sale	3,033
Due after ten years, including assets held for sale	1,994
Mortgage and other asset-backed securities, including assets held for sale	353
Total, including assets held for sale	$ 9,881	$ 9,855

Investments - Gross Unrealized

Investments - Gross Unrealized Appreciation (Depreciation) on Debt Securities by Type of Issuer (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	$ 10,273	$ 10,379
Allowance for Credit Loss, including held for sale assets	(104)	(33)
Unrealized Appreciation, including held for sale assets	242	195
Unrealized Depreciation, including held for sale assets	(530)	(686)
Fair Value, including held for sale assets	9,881	9,855
Federal government and agency
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	273	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	(5)	(8)
Fair Value, including held for sale assets	289	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	373	355
Allowance for Credit Loss, including held for sale assets	0	0
Unrealized Appreciation, including held for sale assets	12	10
Unrealized Depreciation, including held for sale assets	(9)	(13)
Fair Value, including held for sale assets	376	352
Corporate
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	9,212	9,338
Allowance for Credit Loss, including held for sale assets	(104)	(33)
Unrealized Appreciation, including held for sale assets	204	158
Unrealized Depreciation, including held for sale assets	(487)	(630)
Fair Value, including held for sale assets	8,825	8,833
Mortgage and other asset-backed
Debt Securities, Available-for-sale [Line Items]
Amortized cost, including held for sale assets	378	398
Allowance for Credit Loss, including held for sale assets	0	0
Unrealized Appreciation, including held for sale assets	3	1
Unrealized Depreciation, including held for sale assets	(28)	(34)
Fair Value, including held for sale assets	$ 353	$ 365

Investments - Debt Securities w

Investments - Debt Securities with a Decline in Fair Value from Amortized Cost (Details) $ in Millions	Sep. 30, 2024 USD ($) position	Dec. 31, 2023 USD ($) position
Total
Total Fair Value, including held for sale assets	$ 5,856	$ 6,633
Total Amortized Cost, including held for sale assets	6,386	7,319
Total Unrealized Depreciation, including held for sale assets	$ (530)	$ (686)
Total Number of Issues, including held for sale assets | position	1,927	2,353
Investment grade | Debt securities
One year or less
Fair Value, including held for sale assets	$ 202	$ 330
Amortized Cost, including held for sale assets	205	338
Unrealized Depreciation, including held for sale assets	$ (3)	$ (8)
Number of Issues, including held for sale assets | position	112	142
More than one year
Fair Value, including held for sale assets	$ 5,076	$ 5,441
Amortized Cost, including held for sale assets	5,543	6,036
Unrealized Depreciation, including held for sale assets	$ (467)	$ (595)
Number of Issues, including held for sale assets | position	1,382	1,590
Below investment grade | Debt securities
One year or less
Fair Value, including held for sale assets	$ 91	$ 161
Amortized Cost, including held for sale assets	100	170
Unrealized Depreciation, including held for sale assets	$ (9)	$ (9)
Number of Issues, including held for sale assets | position	155	135
More than one year
Fair Value, including held for sale assets	$ 487	$ 701
Amortized Cost, including held for sale assets	538	775
Unrealized Depreciation, including held for sale assets	$ (51)	$ (74)
Number of Issues, including held for sale assets | position	278	486

Investments - Equity Securities

Investments - Equity Securities (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Cost
Equity securities with readily determinable fair values	$ 657	$ 656
Equity securities with no readily determinable fair value	3,117	3,248
Total	3,774	3,904
Carrying Value
Equity securities with readily determinable fair values	49	51
Equity securities with no readily determinable fair value	468	3,311
Total	517	$ 3,362
VillageMD
Carrying Value
Amount of impairments or value changes resulting from observable price changes on equity securities with no readily available fair value still held	$ 2,700

Investments - Commercial Mortga

Investments - Commercial Mortgage Loans (Details) - Real Estate Loan - Commercial Portfolio Segment $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 1,460	$ 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	0.67	0.64
Below 60%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 645	$ 802
Below 60% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	2.15	2.13
60% to 79%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 574	$ 574
60% to 79% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	1.85	1.77
80% to 100%
Schedule of Investments [Line Items]
Carrying value, after allowance for credit loss, including assets held for sale	$ 241	$ 157
80% to 100% | Weighted Average
Schedule of Investments [Line Items]
Average Debt Service Coverage Ratio, including assets held for sale	0.92	0.65

Investments - Other Long-Term I

Investments - Other Long-Term Investments (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Schedule of Investments [Line Items]
Other long term investments, including held for sale assets	$ 4,545	$ 4,181
Real estate investments
Schedule of Investments [Line Items]
Other long-term investments	1,760	1,606
Securities partnerships
Schedule of Investments [Line Items]
Other long-term investments	2,578	2,400
Other
Schedule of Investments [Line Items]
Other long term investments, including held for sale assets	$ 207	$ 175

Investments - Derivative Financ

Investments - Derivative Financial Instruments (Details) - USD ($) $ in Millions	6 Months Ended	9 Months Ended
	Jun. 30, 2024	Sep. 30, 2024	Dec. 31, 2023
Derivative [Line Items]
Derivative gain (loss) reclassified from other comprehensive income into shareholders' net income
Derivative gain (loss) recognized in other comprehensive income
Derivative gain (loss) recognized in the income statement
Designated as Hedging Instrument | Fair Value Hedging | Interest rate swap contracts
Derivative [Line Items]
Notional Value		$ 2,100	$ 1,500

Investments - Realized Investme

Investments - Realized Investment Gains and Losses (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Investments [Abstract]
Net realized investment gains (losses), excluding credit (loss)/recovery and other investment write-downs	$ 25	$ (9)	$ 32	$ (29)
Credit (loss)/recovery and other investment write-downs	(946)	(5)	(2,837)	(15)
Net realized investment (losses), before income taxes	$ (921)	$ (14)	$ (2,805)	$ (44)

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Financial assets at fair value:
Equity securities	$ 49	$ 51
Recurring
Financial assets at fair value:
Equity securities	49	51
Short-term investments	182	206
Debt Securities, including held for sale assets	9,881	9,855
Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	129	132
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	5	4
Quoted Prices in Active Markets for Identical Assets (Level 1) | Recurring
Financial assets at fair value:
Equity securities	1	4
Short-term investments	0	0
Debt Securities, including held for sale assets	168	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	48	47
Short-term investments	182	206
Debt Securities, including held for sale assets	9,290	9,278
Significant Other Observable Inputs (Level 2) | Recurring | Forwards, swaps, options
Financial assets at fair value:
Derivative assets	129	131
Liabilities, Fair Value Disclosure [Abstract]
Derivative liabilities	5	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	423	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	289	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	168	130
Federal government and agency | Significant Other Observable Inputs (Level 2) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	121	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	376	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	376	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	8,825	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	8,448	8,432
Corporate | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	377	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	307	319
Mortgage and other asset-backed | Significant Unobservable Inputs (Level 3) | Recurring
Financial assets at fair value:
Debt Securities, including held for sale assets	$ 46	$ 46

Fair Value Measurements - Quant

Fair Value Measurements - Quantitative Information About Unobservable Inputs (Details) - Recurring - Significant Unobservable Inputs (Level 3) $ in Millions	Sep. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)
Debt securities
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value, including held for sale assets	$ 423	$ 447
Corporate | Securities Priced by the Company
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value, including held for sale assets	$ 377	$ 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	0.0060	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	0.1495	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	0.0380	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	$ 46	$ 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	0.0100	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	0.0635	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	0.0320	0.0310

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Financial Liabilities Carried at Fair Value (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Transfers into / (out of) Level 3
Change in unrealized gain or (loss) included in Other comprehensive income (loss) for assets held at the end of the reporting period	$ 8	$ (4)	$ 3	$ (9)
Debt and Equity Securities
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance		454		447
Beginning balance, including held for sale assets	397		447
Losses included in Shareholders' net income	(10)	(1)	(71)	(1)
Gains (losses) included in Other comprehensive income (loss)	8	(5)	3	(5)
Purchases, sales and settlements
Purchases	4	6	15	10
Sales	(2)	0	(2)	0
Settlements	(4)	(5)	(19)	(32)
Total purchases, sales and settlements	(2)	1	(6)	(22)
Transfers into / (out of) Level 3
Transfers into Level 3	32	0	63	71
Transfers out of Level 3	(2)	(13)	(13)	(54)
Total transfers into / (out of) Level 3	30	(13)	50	17
Ending balance		436		436
Ending balance, including held for sale assets	423		423
Total losses included in Shareholders' net income attributable to instruments held at the reporting date	$ (9)	$ (1)	$ (71)	$ (1)

Fair Value Measurements - Separ

Fair Value Measurements - Separate Accounts (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	$ 600		$ 600		$ 578
Non-guaranteed separate accounts	6,400		6,400		6,172
Subtotal	7,000		7,000		6,750
Non-guaranteed separate accounts priced at NAV as a practical expedient	651		651		680
Separate account assets	7,651		7,651		7,430
Separate Account Assets
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Separate accounts assets classified in Level 3, period increase (decrease), including transfers in and out of Level 3
Pension Plans
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Non-guaranteed separate accounts	4,000		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	247		247		226
Non-guaranteed separate accounts	166		166		158
Subtotal	413		413		384
Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Guaranteed separate accounts	353		353		352
Non-guaranteed separate accounts	6,007		6,007		5,797
Subtotal	6,360		6,360		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		0
Non-guaranteed separate accounts	227		227		217
Subtotal	227		227		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		$ 200

Fair Value Measurements - Sep_2

Fair Value Measurements - Separate Account Assets Priced at Net Asset Value (Details) - Separate Account Assets - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 227
Recurring
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Expected liquidation period after inception	10 years
Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 651	$ 680
Securities partnerships
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	224
Securities partnerships | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	413	419
Real estate and real estate funds
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Unfunded Commitments	$ 3
Real estate and real estate funds | Minimum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	30 days
Real estate and real estate funds | Maximum
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Redemption Notice Period	90 days
Real estate and real estate funds | Recurring | NAV
Fair Value, Investments, Entities that Calculate Net Asset Value Per Share [Line Items]
Fair Value	$ 237	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	$ 1	$ 3

Fair Value Measurements - Asset

Fair Value Measurements - Assets and Liabilities Measured at Fair Value under Certain Conditions (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Equity Securities without Readily Determinable Fair Value, Amount	$ 468		$ 468		$ 3,311
Impairments requiring certain assets and liabilities to be measured at fair value
Equity Securities without Readily Determinable Fair Value, Upward Price Adjustment, Annual Amount
Equity Securities without Readily Determinable Fair Value, Downward Price Adjustment, Annual Amount
VillageMD
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Equity Securities without Readily Determinable Fair Value, Impairment Loss, Annual Amount			$ 2,700

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Disclosures for Financial Instruments Not Carried at Fair Value (Details) - USD ($) $ in Millions	Sep. 30, 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	$ 29,854	$ 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	1,394	1,430
Carrying Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt, including current maturities, excluding finance leases	31,073	29,585
Commercial mortgage loans, including assets held for sale	$ 1,460	$ 1,533

Variable Interest Entities (Det

Variable Interest Entities (Details) - entity	Sep. 30, 2024	Dec. 31, 2023
Variable Interest Entity, Primary Beneficiary
Variable Interest Entity [Line Items]
Number of VIEs	0	0

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	$ 41,527	$ 45,464	$ 46,244	$ 44,688
Other comprehensive income (loss), net of tax	279	(241)	(299)	(461)
Less: Net translation (loss) on foreign currencies attributable to noncontrolling interests	0	0	0	0
Shareholders other comprehensive income (loss), net of tax	279	(241)	(299)	(461)
Balance	42,298	45,702	42,298	45,702
Accumulated Other Comprehensive (Loss)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(2,442)	(1,878)	(1,864)	(1,658)
Shareholders other comprehensive income (loss), net of tax	279	(241)	(299)	(461)
Balance	(2,163)	(2,119)	(2,163)	(2,119)
Securities and Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	400	(118)	171	(332)
Other comprehensive income (loss) before reclassifications, before tax	319	(257)	568	2
Other comprehensive income (loss), before reclassifications, tax	(65)	57	(133)	(9)
Other comprehensive income (loss) before reclassifications, after-tax	254	(200)	435	(7)
Reclassification adjustment, tax	(2)	(3)	(15)	(8)
Net amounts reclassified from AOCI to net income	10	8	58	29
Shareholders other comprehensive income (loss), net of tax	264	(192)	493	22
Balance	664	(310)	664	(310)
Reclassification adjustment for losses included in Shareholders' net income (Net realized investment losses)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	12	12	73	38
Reclassification adjustment for (gains) included in Shareholders' net income (Selling, general and administrative expenses)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Reclassification adjustment, before tax	0	(1)	0	(1)
Net long-duration insurance and contractholder liabilities measurement adjustments
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(1,743)	(704)	(971)	(256)
Shareholders other comprehensive income (loss), net of tax	(28)	(28)	(800)	(476)
Balance	(1,771)	(732)	(1,771)	(732)
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	(34)	(27)	(1,054)	(585)
Other comprehensive income (loss), before reclassifications, tax	3	12	265	149
Other comprehensive income (loss) before reclassifications, after-tax	(31)	(15)	(789)	(436)
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	3	(17)	(15)	(50)
Other comprehensive income (loss), before reclassifications, tax	0	4	4	10
Other comprehensive income (loss) before reclassifications, after-tax	3	(13)	(11)	(40)
Translation of foreign currencies including portion attributable to noncontrolling interest
Accumulated Other Comprehensive Income (Loss) [Line Items]
Other comprehensive income (loss) including temporary equity, before reclassifications, before tax	41	(31)	13	(36)
Other comprehensive income (loss) including temporary equity, before reclassifications, tax	(2)	2	(5)	4
Other comprehensive income (loss), net of tax	39	(29)	8	(32)
Translation of foreign currencies attributable to parent
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(180)	(157)	(149)	(154)
Balance	(141)	(186)	(141)	(186)
Postretirement benefits liability
Accumulated Other Comprehensive Income (Loss) [Line Items]
Balance	(919)	(899)	(915)	(916)
Other comprehensive income (loss) before reclassifications, before tax	(1)	0	(21)	(2)
Other comprehensive income (loss), before reclassifications, tax	1	0	5	1
Other comprehensive income (loss) before reclassifications, after-tax	0	0	(16)	(1)
Reclassification adjustment, tax	(5)	(3)	(8)	(9)
Net amounts reclassified from AOCI to net income	4	8	16	26
Shareholders other comprehensive income (loss), net of tax	4	8	0	25
Balance	(915)	(891)	(915)	(891)
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	$ 9	$ 11	$ 24	$ 35

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Consolidated effective tax rate	30.80%	21.30%	31.20%	19.90%
Deferred tax assets related to investments	$ 836		$ 836
Valuation allowance of deferred tax assets related to investments	$ 635		$ 635

Contingencies and Other Matte_2

Contingencies and Other Matters (Details)			1 Months Ended	9 Months Ended
	Mar. 31, 2022 USD ($)	Apr. 19, 2016 claim	Mar. 31, 2016 USD ($)	Sep. 30, 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

Segment Information - Special I

Segment Information - Special Item Charges (Benefits) (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pre-tax
Impairment of dividend receivable (Net investment income)	$ 182	$ 0	$ 182	$ 0
Integration and transaction-related costs, pre-tax (Selling, General and administrative expenses)	77	13	177	20
(Gain) loss on sale of business	87	21	106	21
Deferred tax (benefits), net (Income taxes, less amount attributable to noncontrolling interests)	0	0	0	0
(Benefits) charges associated with litigation matters (Selling, general and administrative expenses)	0	201	0	201
Total impact from special items	346	235	465	242
After-tax
Impairment of dividend receivable, after-tax (Net investment income)	138	0	138	0
Integration and transaction-related costs, after-tax (Selling, general and administrative expenses)	59	9	135	15
(Gain) loss on sale of business, after-tax	62	19	19	19
Deferred tax (benefits), net, after-tax (Income taxes, less amount attributable to noncontrolling interests)	41	0	75	0
(Benefits) charges associated with litigation matters, after-tax (Selling, general and administrative expenses)	0	171	0	171
Total impact from special items	$ 300	$ 199	$ 367	$ 205

Segment Information - Summarize

Segment Information - Summarized Segment Financial Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information [Line Items]
Revenues from customers	$ 63,609	$ 48,727	$ 180,776	$ 143,275
Net investment income (loss)	85	321	696	876
TOTAL REVENUES	63,694	49,048	181,472	144,151
Net realized investment results from certain equity method investments	(177)	30	(238)	22
Special item related to impairment of dividend receivable	182	0	182	0
Adjusted revenues	63,699	49,078	181,416	144,173
Depreciation and amortization			2,129	2,270
Income before income taxes	1,192	1,840	3,260	5,325
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(99)	(44)	(271)	(142)
Net realized investment (gains) losses	744	44	2,567	66
Amortization of acquired intangible assets	436	454	1,279	1,368
Special items
Impairment of dividend receivable	182	0	182	0
Integration and transaction-related costs	77	13	177	20
(Gain) loss on sale of business	87	21	106	21
(Benefits) charges associated with litigation matters	0	201	0	201
Pre-tax adjusted income (loss) from operations	2,619	2,529	7,300	6,859
Evernorth Health Services
Segment Reporting Information [Line Items]
Revenues from customers	51,552	37,230	144,689	108,462
Cigna Healthcare
Segment Reporting Information [Line Items]
Revenues from customers	11,919	11,426	35,752	34,581
Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	137	71	333	232
Operating Segments | Evernorth Health Services
Segment Reporting Information [Line Items]
Net investment income (loss)	(142)	63	(18)	175
TOTAL REVENUES	52,455	38,596	148,229	112,980
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to impairment of dividend receivable	182		182
Adjusted revenues	52,637	38,596	148,411	112,980
Income before income taxes	631	1,272	1,494	3,318
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	(99)	(44)	(271)	(140)
Net realized investment (gains) losses	748	1	2,203	0
Amortization of acquired intangible assets	414	443	1,247	1,330
Special items
Impairment of dividend receivable	182		182
Integration and transaction-related costs	0	0	0	0
(Gain) loss on sale of business	0	0	0	0
(Benefits) charges associated with litigation matters		44		44
Pre-tax adjusted income (loss) from operations	1,876	1,716	4,855	4,552
Operating Segments | Cigna Healthcare
Segment Reporting Information [Line Items]
Net investment income (loss)	142	176	463	454
TOTAL REVENUES	13,340	12,738	39,821	38,178
Net realized investment results from certain equity method investments	(177)	30	(238)	22
Special item related to impairment of dividend receivable	0		0
Adjusted revenues	13,163	12,768	39,583	38,200
Income before income taxes	1,073	1,019	3,221	3,252
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	0	0	(2)
Net realized investment (gains) losses	(8)	35	359	64
Amortization of acquired intangible assets	22	11	32	38
Special items
Impairment of dividend receivable	0		0
Integration and transaction-related costs	0	0	0	0
(Gain) loss on sale of business	87	0	106	0
(Benefits) charges associated with litigation matters		157		157
Pre-tax adjusted income (loss) from operations	1,174	1,222	3,718	3,509
Operating Segments | Other Operations
Segment Reporting Information [Line Items]
Net investment income (loss)	79	76	231	230
TOTAL REVENUES	234	147	627	462
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to impairment of dividend receivable	0		0
Adjusted revenues	234	147	627	462
Income before income taxes	(10)	(3)	(9)	47
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	0	0	0
Net realized investment (gains) losses	4	8	5	2
Amortization of acquired intangible assets	0	0	0	0
Special items
Impairment of dividend receivable	0		0
Integration and transaction-related costs	0	0	0	0
(Gain) loss on sale of business	0	21	0	21
(Benefits) charges associated with litigation matters		0		0
Pre-tax adjusted income (loss) from operations	(6)	26	(4)	70
Corporate and Eliminations
Segment Reporting Information [Line Items]
TOTAL REVENUES	(2,335)	(2,433)	(7,205)	(7,469)
Adjusted revenues	(2,335)	(2,433)	(7,205)	(7,469)
Corporate
Segment Reporting Information [Line Items]
Revenues from customers	1	0	2	0
Net investment income (loss)	6	6	20	17
Net realized investment results from certain equity method investments	0	0	0	0
Special item related to impairment of dividend receivable	0		0
Income before income taxes	(502)	(448)	(1,446)	(1,292)
Pre-tax adjustments to reconcile to adjusted income from operations
(Income) loss attributable to noncontrolling interests	0	0	0	0
Net realized investment (gains) losses	0	0	0	0
Amortization of acquired intangible assets	0	0	0	0
Special items
Impairment of dividend receivable	0		0
Integration and transaction-related costs	77	13	177	20
(Gain) loss on sale of business	0	0	0	0
(Benefits) charges associated with litigation matters		0		0
Pre-tax adjusted income (loss) from operations	(425)	(435)	(1,269)	(1,272)
Intersegment Eliminations
Segment Reporting Information [Line Items]
Revenues from customers	(2,342)	(2,439)	(7,227)	(7,486)
Intersegment Eliminations | Evernorth Health Services
Segment Reporting Information [Line Items]
Revenues from customers	(1,045)	(1,303)	(3,558)	(4,343)
Intersegment Eliminations | Cigna Healthcare
Segment Reporting Information [Line Items]
Revenues from customers	(1,279)	(1,136)	(3,606)	(3,143)
Intersegment Eliminations | Other Operations
Segment Reporting Information [Line Items]
Revenues from customers	$ (18)	$ 0	$ (63)	$ 0

Segment Information - Revenue f

Segment Information - Revenue from External Customers (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue from External Customer [Line Items]
Premiums	$ 11,436	$ 10,998	$ 34,493	$ 33,062
Total revenues from external customers	63,609	48,727	180,776	143,275
Pharmacy revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	48,284	34,531	135,421	100,639
Service
Revenue from External Customer [Line Items]
Revenue from contract with customer	3,889	3,198	10,862	9,574
Evernorth Health Services
Revenue from External Customer [Line Items]
Total revenues from external customers	51,552	37,230	144,689	108,462
Cigna Healthcare
Revenue from External Customer [Line Items]
Total revenues from external customers	11,919	11,426	35,752	34,581
Other Operations
Revenue from External Customer [Line Items]
Total revenues from external customers	137	71	333	232
Intersegment Eliminations
Revenue from External Customer [Line Items]
Premiums	18	17	73	51
Total revenues from external customers	(2,342)	(2,439)	(7,227)	(7,486)
Intersegment Eliminations | Pharmacy revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	(982)	(1,109)	(3,238)	(3,890)
Intersegment Eliminations | Service
Revenue from External Customer [Line Items]
Revenue from contract with customer	(1,378)	(1,347)	(4,062)	(3,647)
Intersegment Eliminations | Evernorth Health Services
Revenue from External Customer [Line Items]
Total revenues from external customers	(1,045)	(1,303)	(3,558)	(4,343)
Intersegment Eliminations | Cigna Healthcare
Revenue from External Customer [Line Items]
Total revenues from external customers	(1,279)	(1,136)	(3,606)	(3,143)
Intersegment Eliminations | Other Operations
Revenue from External Customer [Line Items]
Total revenues from external customers	(18)	0	(63)	0
Operating Segments | Other revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	267	43	509	172
Operating Segments | Evernorth Health Services | Pharmacy revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	49,252	35,640	138,612	104,529
Operating Segments | Evernorth Health Services | Network revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	27,353	16,926	76,795	49,080
Operating Segments | Evernorth Health Services | Home delivery and specialty revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	18,909	16,324	53,384	48,943
Operating Segments | Evernorth Health Services | Other revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	2,990	2,390	8,433	6,506
Operating Segments | Evernorth Health Services | Fees
Revenue from External Customer [Line Items]
Revenue from contract with customer	3,314	2,862	9,508	8,199
Operating Segments | Cigna Healthcare
Revenue from External Customer [Line Items]
Premiums	11,296	10,911	34,135	32,786
Operating Segments | Cigna Healthcare | Fees
Revenue from External Customer [Line Items]
Revenue from contract with customer	1,671	1,639	4,850	4,847
Operating Segments | Cigna Healthcare | U.S. Healthcare
Revenue from External Customer [Line Items]
Premiums	10,385	10,077	31,448	30,346
Operating Segments | Cigna Healthcare | U.S. Healthcare | Employer insured
Revenue from External Customer [Line Items]
Premiums	4,382	4,144	13,125	12,315
Operating Segments | Cigna Healthcare | U.S. Healthcare | Medicare Advantage
Revenue from External Customer [Line Items]
Premiums	2,110	2,189	6,604	6,605
Operating Segments | Cigna Healthcare | U.S. Healthcare | Stop loss
Revenue from External Customer [Line Items]
Premiums	1,689	1,548	5,022	4,565
Operating Segments | Cigna Healthcare | U.S. Healthcare | Individual and Family Plans
Revenue from External Customer [Line Items]
Premiums	1,001	1,269	3,016	3,770
Operating Segments | Cigna Healthcare | U.S. Healthcare | Other
Revenue from External Customer [Line Items]
Premiums	1,203	927	3,681	3,091
Operating Segments | Cigna Healthcare | International Health
Revenue from External Customer [Line Items]
Premiums	911	834	2,687	2,440
Operating Segments | Other Operations
Revenue from External Customer [Line Items]
Premiums	122	70	285	225
Operating Segments | Other Operations | Pharmacy revenues
Revenue from External Customer [Line Items]
Revenue from contract with customer	14	0	47	0
Operating Segments | Other Operations | Fees
Revenue from External Customer [Line Items]
Revenue from contract with customer	$ 15	$ 1	$ 57	$ 3

Segment Information - Financial

Segment Information - Financial and Performance Guarantees (Details) - USD ($) $ in Billions	Sep. 30, 2024	Dec. 31, 2023
Evernorth Health Services | Guarantees
Loss Contingencies [Line Items]
Guarantee liability	$ 2	$ 1.6

Segment Information - Major Cus

Segment Information - Major Customers (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Loss Contingencies [Line Items]
Revenues from external customers	$ 63,609	$ 48,727	$ 180,776	$ 143,275
Revenue | Customer Concentration Risk | Single Pharmacy Benefit Client
Loss Contingencies [Line Items]
Concentration percentage	16%		16%
Revenue | Customer Concentration Risk | U.S. Federal Government Agencies
Loss Contingencies [Line Items]
Concentration percentage	10%		11%