The Cigna Group
| Company type | Public |
|---|---|
| Industry | Managed healthcare, Insurance |
| Predecessor | Connecticut General Life Insurance Company, INA Corporation |
| Founded | 1982 |
| Headquarters | Bloomfield, Connecticut , United States |
Area served | Worldwide |
Key people | David Cordani (CEO) |
| Products | Medical, dental, disability, life, and accident insurance; pharmacy benefit management (via Express Scripts) |
Number of employees | 73,500 (2024) |
| Website | www |
The Cigna Group is a U.S.-based multinational corporation specializing in managed healthcare and insurance services, with its main office located in Bloomfield, Connecticut. Its affiliated companies offer a range of insurance products and services, including medical, dental, disability, life, and accident coverage. These offerings are primarily distributed through employer-sponsored plans and group arrangements with entities such as government bodies, labor unions, and professional associations. The company is legally incorporated in Delaware.
Placed 15th on the 2023 Fortune 500 ranking by revenue and 68th on the 2023 Forbes Global 2000, Cigna reported revenues of $247.1 billion for the fiscal year 2024. The company achieved an operating income of $9.417 billion and a net profit of $3.434 billion during the same period. Its workforce numbers around 73,500 employees.
Cigna's operational strategy centers on delivering integrated healthcare solutions, notably through its subsidiary Express Scripts, a leading firm in pharmacy benefit management (PBM). Under the leadership of CEO David Cordani, the company has expanded both its domestic footprint and international reach.
Despite its strong market position and financial results, Cigna has encountered criticism related to instances where insurance claims were automatically denied without adequate review.
History
The inception of Cigna dates back to 1982 when Connecticut General Life Insurance Company (CG) merged with INA Corporation, which owned the Insurance Company of North America (INA), recognized as America’s first publicly traded insurance company. The brand name "Cigna" is derived by merging elements from CG and INA. INA was established in 1792, while CG was founded in 1865 following legislation enacted by a Connecticut governor. A notable historical moment for INA was its full settlement of claims after the Chicago Fire of 1871, setting it apart from other insurers at the time.
In 1997, Cigna divested most of its life insurance business to Lincoln National Corporation. Later, in October 2011, it acquired HealthSpring Inc. for $3.8 billion to significantly grow its Medicare Advantage membership from 46,000 to nearly 400,000 individuals. This acquisition was funded through a combination of equity issuance, cash reserves, and debt financing. By 2013, Cigna had operations spanning 30 countries with a workforce of approximately 35,800 employees and managed assets totaling around $53.7 billion.
In June 2015, Anthem Inc. proposed a $47 billion deal involving cash and stock to purchase Cigna; this offer was officially accepted in July. However, the U.S. Department of Justice filed an antitrust lawsuit in July 2016 aiming to block the merger. In February 2017, a federal court ruled against the acquisition citing anticompetitive concerns, prompting Cigna to cancel the $48 billion agreement. Legal disputes between the two corporations continued until August 2020 when they concluded without any compensation being awarded.
On March 7, 2018, Cigna announced its plan to acquire Express Scripts for $67 billion; shareholders approved this transaction in August 2018. By June 2020, Cigna entered into a strategic partnership with Priority Health to improve access to affordable healthcare coverage for employers in Michigan.
In September 2020, Cigna consolidated its health services under the new brand Evernorth, which includes Express Scripts, Accredo, and eviCore. The following month saw Cigna renew its network contract with Envision Healthcare to serve members in Florida. In 2021, Molina Healthcare purchased Cigna’s Medicaid contracts in Texas for $60 million.
On February 13, 2023, Cigna restructured its corporate identity: renaming its parent entity as The Cigna Group; rebranding its health benefits division as Cigna Healthcare; and designating its health services segment as Evernorth Health Services.
In January 2024, Cigna agreed to sell its Medicare Advantage plans along with Supplemental Benefits, Medicare Part D offerings, and CareAllies operations to Health Care Service Corporation (HCSC) for roughly $3.7 billion. The agreement includes a four-year service contract whereby Evernorth will continue managing pharmacy benefits for Medicare members. This transaction is anticipated to finalize in early 2025 pending regulatory clearance.
Cigna Global Health Benefits
Cigna Global Health Benefits (CGHB) functions as a division of Cigna Corporation, with its main headquarters located in Wilmington, Delaware, in proximity to Philadelphia. The company also maintains offices in Visalia, California, Greenock, Scotland, Shanghai, China, and Antwerp, Belgium, while operating sales branches throughout North America, Europe, Asia, and the Middle East.
Products and services
CGHB provides a range of international health insurance plans designed specifically for expatriates—employees of global corporations working abroad. Their offerings encompass medical, dental, behavioral health, disability, business travel, and life insurance coverage. The division oversees its proprietary international claims system and grants access to a network exceeding 550,000 healthcare providers in the U.S. and 141,000 globally.
Public relations and lobbying
From 2005 through 2009, Cigna allocated more than $4.4 million toward lobbying activities aimed at shaping legislation beneficial to the company. In 2009 alone, expenditures reached $720,000 distributed among 20 lobbyists across five firms. In 2008, Wendell Potter, who led Cigna’s public relations department at the time, resigned and subsequently testified before the U.S. Senate advocating for health care reform.
Claims denial practices
In 2023, criticism arose against Cigna for implementing a system named "PXDX," which permitted company-employed physicians to deny claims without examining patient records. This approach facilitated the rapid rejection of over 300,000 claims within a two-month period—averaging approximately 1.2 seconds per claim—thereby lowering expenses by circumventing thorough case reviews. Internally called "click and close," this practice sparked concerns regarding transparency in claim handling and patient billing procedures.
Nataline Sarkisyan liver transplant case
In December 2007, Cigna declined coverage for a liver transplant for California teenager Nataline Sarkisyan, leading to widespread public attention. Although an appropriate liver donor was available and medical experts estimated a 65% likelihood she would survive at least six months post-transplant, Cigna initially refused payment. After public outcry, the insurer reversed its stance; however, Sarkisyan passed away while awaiting the procedure.
Despite liver transplants being an established treatment since 1963, Cigna justified its denial by citing inadequate evidence concerning the safety and efficacy of the transplant for Sarkisyan’s specific condition. The California judiciary upheld Cigna’s position, ruling that federal ERISA law preempted the Sarkisyans' legal claims. On April 16, 2009, the U.S. District Court dismissed all lawsuits against Cigna related to this coverage decision.
The UK publication Guardian featured this case in their Esc and Ctrl videoblog series addressing corporate influence on the Internet. The segment included commentary from a former Cigna vice president discussing astroturfing—the practice of companies producing fake blogs to sway media coverage and public opinion on topics such as universal health care.
Other controversies
In 2002, Cigna was accused of breaching the Securities Exchange Act through earnings manipulation that contributed to a significant decline in its stock value.
The American Customer Satisfaction Index ranked Cigna among the least favored companies in the U.S. in both 2015 and 2018, reflecting ongoing customer satisfaction challenges.
In August 2020, the Department of Justice initiated a $1.4 billion lawsuit against Cigna over allegations that it submitted fraudulent diagnostic codes to Medicare Advantage, Medicare, and Medicaid programs.
Later that year in November 2020, shareholders filed suit against CEO David Cordani and the board of directors accusing them of employing aggressive strategies to block a proposed merger with Anthem in 2017. The complaint alleged Cordani aimed to undermine the merger after failing to secure leadership roles within the combined company by utilizing legal maneuvers and public relations tactics described as a "Trojan Horse" campaign. Had it succeeded, this merger would have formed the largest health insurer in the United States at that time.
Evaluations
Cigna was awarded gold in the 2009 Gartner & 1to1 Customer Experience Excellence Award, recognizing its exceptional customer relationship management and service execution.
In January 2010, Cigna secured its fourth straight JD Power accolade for superior customer service performance across all its call centers.
Conversely, a 2011 analysis by the California Nurses Association revealed that Cigna rejected nearly 39.6% of claims, a rate substantially higher than competitors such as Aetna, which denied roughly 5.9% during the same timeframe.
Strategic alliances
On April 16, 2010, Cigna entered into a partnership with Humana to provide simplified Medicare Advantage options tailored for employer clients' retired employees. In November 2023, reports emerged about a proposed $60 billion merger between Cigna and Humana; however, by December 2023, these negotiations were halted, with Cigna opting instead for a major share repurchase initiative.
In November 2011, Cigna collaborated with India's TTK Group to establish a joint venture named Cigna TTK, designed to enhance health insurance offerings within the Indian market, subject to regulatory clearance.