CIGNA CORPORATION INVESTOR PRESENTATION

Transcription

1 CIGNA CORPORATION INVESTOR PRESENTATION May 3, 2018

2 Forward-looking statements and non-gaap measures CAUTIONARY STATEMENT FOR PURPOSES OF THE SAFE HARBOR PROVISIONS OF THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995 This press release, and oral statements made with respect to information contained in this release, may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of Forward-looking statements are based on Cigna's current expectations and projections about future trends, events and uncertainties. These statements are not historical facts. Forwardlooking statements may include, among others, statements concerning our projected adjusted income (loss) from operations outlook for 2018, on both a consolidated and segment basis; projected total revenue growth and global medical customer growth, each over year end 2017; projected growth beyond 2018; projected medical care and operating expense ratios and medical cost trends; our projected consolidated adjusted tax rate; future financial or operating performance, including our ability to deliver personalized and innovative solutions for our customers and clients; future growth, business strategy, strategic or operational initiatives; economic, regulatory or competitive environments, particularly with respect to the pace and extent of change in these areas; financing or capital deployment plans and amounts available for future deployment; our prospects for growth in the coming years; the proposed merger (the Merger ) with Express Scripts Holding Company ( Express Scripts ) and other statements regarding Cigna's future beliefs, expectations, plans, intentions, financial condition or performance. You may identify forward-looking statements by the use of words such as believe, expect, plan, intend, anticipate, estimate, predict, potential, may, should, will or other words or expressions of similar meaning, although not all forward-looking statements contain such terms. Forward-looking statements are subject to risks and uncertainties, both known and unknown, that could cause actual results to differ materially from those expressed or implied in forward-looking statements. Such risks and uncertainties include, but are not limited to: our ability to achieve our financial, strategic and operational plans or initiatives; our ability to predict and manage medical costs and price effectively and develop and maintain good relationships with physicians, hospitals and other health care providers; the impact of modifications to our operations and processes; our ability to identify potential strategic acquisitions or transactions and realize the expected benefits of such transactions, including with respect to the Merger; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; the outcome of litigation, regulatory audits, investigations, actions and/or guaranty fund assessments; uncertainties surrounding participation in government-sponsored programs such as Medicare; the effectiveness and security of our information technology and other business systems; unfavorable industry, economic or political conditions, including foreign currency movements; acts of war, terrorism, natural disasters or pandemics; our ability to obtain shareholder or regulatory approvals required for the Merger or the requirement to accept conditions that could reduce the anticipated benefits of the Merger as a condition to obtaining regulatory approvals; a longer time than anticipated to consummate the proposed Merger; problems regarding the successful integration of the businesses of Express Scripts and Cigna; unexpected costs regarding the proposed Merger; diversion of management s attention from ongoing business operations and opportunities during the pendency of the Merger; potential litigation associated with the proposed Merger; the ability to retain key personnel; the availability of financing, including relating to the proposed Merger; effects on the businesses as a result of uncertainty surrounding the proposed Merger; as well as more specific risks and uncertainties discussed in our most recent report on Form 10-K and subsequent reports on Forms 10-Q and 8-K available on the Investor Relations section of as well as on Express Scripts most recent report on Form 10-K and subsequent reports on Forms 10-Q and 8-K available on the Investor Relations section of You should not place undue reliance on forward-looking statements, which speak only as of the date they are made, are not guarantees of future performance or results, and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Cigna undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise, except as may be required by law. NON-GAAP MEASURES AND FINANCIAL INFORMATION The Company uses adjusted income from operations as the principal measure of performance when describing its financial results and outlook. On a consolidated basis, adjusted income from operations is not determined in accordance with accounting principles generally accepted in the United States of America ( GAAP ). Adjusted income from operations is defined as shareholders net income (loss) excluding after-tax realized investment results, net amortization of other acquired intangible assets, special items and, for periods ended on or prior to December 31, 2014, the results of Cigna s Guaranteed Minimum Income Benefits (GMIB) business. Management uses adjusted income from operations to measure financial performance because it presents underlying results of operations and permits analysis of trends in underlying revenue, expenses and shareholders net income. On a consolidated basis, adjusted income from operations should not be viewed as a substitute for the most directly comparable GAAP measure - shareholders net income. *In this presentation, the term earnings means adjusted income from operations and earnings per share means adjusted income from operations on a fully diluted per share basis. The appendix to this presentation contains a reconciliation of adjusted income from operations on a consolidated basis to shareholders net income, the most directly comparable GAAP measure. Management is unable to provide a forward-looking reconciliation of adjusted income from operations to shareholders net income for full year 2018 because future net realized investment results, net amortization of other acquired intangible assets and special items cannot be identified or reasonably estimated at this time. Peer information is presented on the basis of their respective principal financial performance measure. 2

3 Important information for investors IMPORTANT INFORMATION ABOUT THE TRANSACTION AND WHERE TO FIND IT This communication does not constitute an offer to buy or solicitation of an offer to sell any securities. In connection with the proposed transaction, the newly formed company which will become the holding company following the transaction ( Holdco ) intends to file with the SEC a registration statement on Form S-4 that will include a joint proxy statement of Cigna and Express Scripts that also constitutes a prospectus of Holdco. Cigna and Express Scripts also plan to file other relevant documents with the SEC regarding the proposed transaction. INVESTORS AND SECURITY HOLDERS ARE URGED TO READ THE JOINT PROXY STATEMENT/PROSPECTUS AND OTHER RELEVANT DOCUMENTS FILED WITH THE SEC CAREFULLY AND IN THEIR ENTIRETY IF AND WHEN THEY BECOME AVAILABLE BECAUSE THEY WILL CONTAIN IMPORTANT INFORMATION. You may obtain a free copy of the joint proxy statement/prospectus (if and when it becomes available) and other relevant documents filed by Holdco, Cigna and Express Scripts with the SEC at the SEC s website at Copies of documents filed with the SEC by Cigna will be available free of charge on Cigna s website at or by contacting Cigna s Investor Relations Department at (215) Copies of documents filed with the SEC by Express Scripts will be available free of charge on Express Scripts website at or by contacting Express Scripts Investor Relations Department at (314) PARTICIPANTS IN THE SOLICITATION Cigna (and, in some instances, Holdco) and Express Scripts and their respective directors and executive officers may be deemed to be participants in the solicitation of proxies in respect of the proposed transaction under the rules of the SEC. Investors may obtain information regarding the names, affiliations and interests of directors and executive officers of Cigna (and, in some instances, Holdco) in Cigna s Annual Report on Form 10-K for the year ended December 31, 2017, which was filed with the SEC on February 28, 2018, and its definitive proxy statement for its 2018 Annual Meeting, which was filed with the SEC on March 16, Investors may obtain information regarding the names, affiliations and interests of Express Scripts directors and executive officers in Express Scripts Annual Report on Form 10-K for the year ended December 31, 2017, which was filed with the SEC on February 27, 2018, and its proxy statement for its 2018 Annual Meeting, which was filed with the SEC on March 29, You may obtain free copies of these documents at the SEC s website at at Cigna s website at or by contacting Cigna s Investor Relations Department at (215) Copies of documents filed with the SEC by Express Scripts will be available free of charge on Express Scripts website at or by contacting Express Scripts Investor Relations Department at (314) Other information regarding the participants in the proxy solicitation and a description of their direct and indirect interests, by security holdings or otherwise, will be contained in the joint proxy statement/prospectus and other relevant materials to be filed with the SEC regarding the proposed transaction if and when they become available. Investors should read the joint proxy statement/prospectus carefully and in its entirety when it becomes available before making any voting or investment decisions. NO OFFER OR SOLICITATION This communication is for informational purposes only and not intended to and does not constitute an offer to subscribe for, buy or sell, the solicitation of an offer to subscribe for, buy or sell or an invitation to subscribe for, buy or sell any securities or the solicitation of any vote or approval in any jurisdiction pursuant to or in connection with the proposed transaction or otherwise, nor shall there be any sale, issuance or transfer of securities in any jurisdiction in contravention of applicable law. No offer of securities shall be made except by means of a prospectus meeting the requirements of Section 10 of the Securities Act of 1933, as amended, and otherwise in accordance with applicable law. 3

4 Table of contents Identity and mission Strong track record Growth platforms Financial priorities and expectations Cigna and Express Scripts combination Investor considerations 4

5 Identity and mission Who We Are We are a Global Health Service Company Our Mission To improve the health, well-being and sense of security of the people we serve Our Role To be champions for our customers and our communities 5

6 Global footprint USA Canada U.K. Belgium Ireland Spain Portugal France Netherlands Denmark, Norway, Sweden Germany Italy Lebanon Switzerland Turkey Saudi Arabia Kuwait Bahrain UAE Oman China Hong Kong India Thailand South Korea Taiwan Operating in 30+ countries/jurisdictions Global medical network across 190+ countries More than 45,000 employees Over 95 million customer relationships Indonesia Singapore Australia New Zealand Well established in attractive geographies 6

7 Strong track record in a challenging market 7

8 Achieving strong performance 8-Year Revenue CAGR 11% 8-Year EPS * CAGR 13% ($ in billions) $21.1 $21.9 $18.3 $39.7 $41.6 $37.9 $32.4 $34.9 $29.1 $4.07 $4.53 $5.11 $6.49 $7.29 $7.87 $8.66 $8.10 $ Total Revenue Earnings Per Share Delivered cumulative Total Shareholder Return of 479% from YE 2009 YE 2017 Double-digit top-line and bottom-line growth over an 8-year period *A reconciliation of earnings per share to shareholders net income per share, the most directly comparable GAAP measure, can be found in the Appendix. 8

9 Strong margins and ROIC drive financial flexibility After-tax margins Returns on invested capital 4.7% 4.7% 6.1% 11% 12% 12% 14% 3.0% 4.0% 7% Humana Anthem Aetna United Cigna Anthem Aetna Humana United Cigna After-tax margins and returns on invested capital are annual averages for

10 Strong record of total shareholder return Average annual TSR * 36% 26% 21% 16% Cigna Managed Care ** Peer Group *** S&P 500 Cigna delivered cumulative TSR of 479% from YE 2009 YE 2017 *Annual average TSRs are presented for full years 2009 through **Managed Care includes: Aetna, Anthem, Humana and UnitedHealth. ***Broader peer group includes: Aetna, Aflac, Anthem, The Hartford, HealthNet (through 2015), Humana, Manulife, MetLife, Unum and UnitedHealth. 10

11 Evolved strategy expands avenues for growth and performance through enhanced customer value 11

12 Global market forces Aging population Eroding health status Changing role of consumers Technological innovation Regulatory and legislative climate Affordability and accessibility challenges drive key needs for the people we serve Customers Clients Health Care Professionals Communities Government Personalized, affordable solutions Greater affordability and productivity Value-based partnering and care delivery Improved health, vitality and productivity Access and affordability solutions Tremendous need for personalization, affordability and predictability 12

13 Cigna s enterprise strategy Go Deeper Go Local Go Beyond To expand and deepen our customer, client and partner relationships; depth in targeted sub-segments, geographies To ensure our solution suite and services meet customer, client and partner needs at a local market level To innovate and further differentiate our businesses, the experiences we deliver, and overall social impact 13

14 How we will win Focus on differentiated strengths STRATEGIC IMPERATIVES ENABLERS OBJECTIVE Be the Undisputed Partner of Choice Accelerating Next Generation Integration Make the Complex Simpler Affordability Personalization Customer Value To win in the marketplace, we focus on our differentiated strengths to create unique and sustainable value for our customers driven by achieving the right balance of Affordability and Personalization delivered through three key strategic imperatives 14

15 Continuing to deliver differentiated value and growth from our four growth platforms 15

16 Targeted growth platforms COMMERCIAL EMPLOYER SENIORS GLOBAL SUPPLEMENTAL BENEFITS GROUP DISABILITY AND LIFE High single-digit average annual enterprise revenue growth target over the long term 16

17 Global Health Care Commercial employer Business overview / How we win Growth & margins Leverage information, incentives and care resources to help health care providers better align around value-based care models, to deliver a differentiated, more coordinated approach to care Deeply integrated medical and specialty offerings allow us to leverage the combined data and insights across our solutions to improve outcomes for the benefit of customers and clients 8% Revenue CAGR Innovative solutions to meet market needs and actively improve the customer experience through new technology and digital enablement solutions Unique capabilities in the underserved lives segment, including integrated administrative services only (ASO) with Stop Loss solutions, onsite medical management programs and transparent reporting of cost drivers 2009 Delivered avg. annual after-tax margins: High single digits 2017 Product portfolio/customer profile Products & Services Funding Solutions Medical Customers* Medical Pharmacy ASO ~13.8M customers Stop Loss Dental Behavioral Health Advocacy & Coaching Experience Rated Guaranteed Cost Over 2.3M customers in collaborative arrangements ~85% of customers in ASO arrangements * As of 3/31/18 17

18 Commercial employer Medical cost trend Leading U.S. total medical cost trend results 8% Reported Medical Cost Trend Reported Medical Cost Trend 7% 6% 2018 Medical Cost Trend Guidance 5.5% 6.5% 5.5% 6.5% 6% 4% CI AET ANTM UNH 5% 4% 3% 4% 5% 2% ANTM UNH CI Superior results driven by key differentiators: Consumer engagement and alignment of incentives Integrated medical and specialty solutions Advanced Cigna collaborative care arrangements with providers Trends represent total book of business, all funding arrangements. Reported results for Cigna consistent with external disclosure; for 2013, 2016, and 2017, final disclosure was less than 5%, less than 4%, and less than 3%, respectively. 18

19 Commercial employer Medical customer growth Only company in our peer group to deliver total medical customer* growth for 8 consecutive years Number of customers** (000) Number of customers** (000) 1,600 1,500 1,400 1,300 1,200 1,100 1, Number of customers** (000) 6,000 5,500 5,000 4,500 4,000 3,500 3,000 2,500 2,000 Select Segment***: 13% average annual growth National Accounts: Maintaining share in a stable market ,000 11,000 10,000 9,000 8,000 7,000 6,000 5,000 4,000 Middle Market Segment***: 4% average annual growth *Medical customers include individuals who meet any one of the following criteria: are covered under a medical insurance policy, managed care arrangement or service agreement issued by Cigna; have access to Cigna s provider network for covered services under their medical plan; or have medical claims and services that are administered by Cigna. **As of 12/31/17. ***Presentation above treats Select Segment as Employer groups with employees and Middle Market as employer groups with employees. 19

20 Commercial employer Consultative approach Designing customized benefit programs and offering a variety of funding mechanisms to meet each client s specific needs Solution Based Seek Alignment Simplifying the Complex Funding agnostic to satisfy differentiated market needs 20

21 Commercial employer Integration of specialty solutions Creating personalized value for customers by harnessing insights to improve outcomes Penetration Rates Book of Business Low Low-Mid Mid-High High Some examples: Behavioral Vision EAP Disability Oncology Stop Loss Prenatal Program Pharmacy Dental Chronic Condition Management Behavioral Utilization & Case Management Reduces medical costs by helping people quit smoking and manage weight and stress Pharmacy Medical cost savings through additional customer touchpoints, driving more health engagement in specialty condition management, case management and health coaching 50 70% Less than 30% 30 50% Over 70% Dental Appropriate treatment of gum disease drives lower medical costs for those with diabetes, heart disease and stroke Penetration rates as a percentage of total medical customer base; does not include non-medical customers. 21

22 Commercial Employer Cigna Collaborative Care 1 Developing value-based care programs for our Commercial customers for a decade, and almost two decades for Medicare Advantage customers IA 212 Accountable Care programs 167 Specialist programs 140 Hospital programs 7 Delivery system joint ventures Top performing participating Accountable Care program providers demonstrated a quality performance of 10% or better than market 2 and saved 3.2% in total medical cost. 3 99% of our customers in the U.S. are within 15 miles of a provider in a Accountable Care program arrangement Cigna internal analysis of existing arrangements as of April Subject to change. Map is illustrative. 2. Cigna July 2017 analysis (weighted average) of top seven Accountable Care program groups nationally, per metric compared to local market in Comparisons to market are established using Cigna internal claims data. 3. Cigna June 2017 analysis of 2016 data of Accountable Care program groups nationally, active at least one year, that achieved savings. Average saved compared to market PMPM trend for 2015 and Cigna August 2017 analysis of national medical book of business customers in the top 40 US markets, defined by market size, within 15-mile zip code radius (zip code to zip code distance) of one Accountable Care program physician. Subject to change. 22

23 Commercial employer Personalized solutions Bringing our approach to personalization to life through innovative new solutions Making the complex simpler to improve the customer experience Personal care delivered by local value-based providers 23

24 Global Health Care Seniors Business overview/how we win Medicare Advantage (MA) Unique model focused on engagement and risk-sharing arrangements with physicians Strong clinical capabilities and extensive experience in care coordination Top 3 market presence in our established MA markets Ongoing member satisfaction and high-quality programs MA Part D strong networks and formularies with focus on improving total pharmacy costs Growth & margins 25% Revenue CAGR* 2009 Delivered avg. annual after-tax margins: Low single digits 2017 Product portfolio/customer profile Medicare Advantage Footprint MA Part D 433,000 customers** 60% of customers in 4 star or greater plans in 2018 Presence in 16 states Expect to expand into 1 2 new markets per year 784,000 customers** * 25% revenue CAGR includes inorganic growth from the HealthSpring acquisition in January ** As of 3/31/18. 24

25 Seniors Provider engagement model Provider engagement model is a differentiator Year-over-year improvements Over 85% in clinical of our quality measures customers are cared for by a provider in a value-based arrangement Partner with providers Pioneer in valuebased care Help physicians remain independent 25

26 Seniors Customer experience Delivering a positive customer experience Positive customer satisfaction Year-over-year improvements in clinical quality measures Strength in customer likelihood to recommend, NPS* as high as performance resulted in over 80% of all HEDIS* Star measures exceeding prior-year rates or maintaining 5 Star performance Positioned for strong, sustained customer growth *NPS is net promoter score; HEDIS stands for Health Care Effectiveness Data and Information Set. 26

27 Global Supplemental Benefits Business overview/how we win Growth & margins Leveraging deep consumer insights to drive product innovation and optimize distribution Meeting the rapidly growing demand for health protection needs Targeting the growing middle class and seniors populations globally Leading innovative, direct to consumer distribution capabilities Easy to understand, affordable products that are designed to fill in gaps in coverage 17% Revenue CAGR Locally licensed and managed by strong, locally developed talent 2009 Delivered avg. annual after-tax margins: High single digits 2017 Product portfolio Fixed cash payments Health Other Hospitalization Critical Illness Personal Accident Medicare Supplement Individual Private Medical Dental Travel Term Life Variable Life 27

28 Global Supplemental Benefits Distribution channels Diversity of distribution model distinguishes Cigna from competitors 2017 Sales by Distribution Channel Individual Agent/Broker 31% 18% Bancassurance 19% 32% Telemarketing Direct to Consumer 28

29 Group Disability and Life Business overview/how we win Disability absence management model that reduces overall costs to employers Integration of disability products with medical and specialty offerings, promoting health and wellness, and optimizing employee productivity Complementary portfolio of group disability, life and accident offerings Best-in-class return-to-work results that enhance workforce productivity for employers Growth & margins 4% Revenue CAGR 2009 Delivered avg. annual after-tax margins: High single digits 2017 Product portfolio Disability Life Accident Short-term Long-term FMLA Basic-term Voluntary term Group universal Personal basic/voluntary Business travel Critical Illness/Accidental Injury 29

30 Group Disability and Life Disability resolution rates Industry-leading return-to-work rates Disability resolution rates* Cigna Industry Median 9.6% 9.9% 9.3% 10.1% 10.4% 9.5% Superior results driven by key differentiators: Pioneer in value based care Integration with medical benefits enables earlier intervention, quicker decisions and increased resolutions High investments into pre-disability and absence prediction and prevention programs that decrease the time a customer is away from work Significant clinical and vocational interventions soon after the onset of a disability and at recurring intervals thereafter * Resolution rates above represent percentage of customers on disability who returned to active service within 12 months of their initial date of receiving disability benefits. 30

31 Financial expectations and priorities 31

32 2018 Outlook* ($ in millions, except per share amounts) Earnings** 2018 Outlook % Growth Global Health Care $2,670 - $2,730 Global Supplemental Benefits $390 - $410 Group Disability and Life $330 - $350 Ongoing Businesses $3,390 - $3,490 20% - 23% Consolidated $3,170 - $3,270 19% - 23% Earnings Per Share* $ $ % - 27% Ongoing contributions across a diversified portfolio of businesses *Outlook provided in Cigna s earnings release on May 3, 2018 and excludes the potential effects of future capital deployment and additional prior year reserve development. **See page 2 for definitions of earnings and earnings per share. 32

33 Long-term target margins and revenue growth Business Long-term Target Revenue Growth Long-term Target After-tax Margins - Commercial Employer High single digits Mid to high single digits Medicare Advantage High single digits Low to mid single digits Global Supplemental Benefits Mid teens High single digits Group Disability & Life Mid single digits Mid to high single digits 33

34 Capital deployment priorities Forward view Reinvesting in businesses to support long-term growth Strategic M&A to enhance capabilities and scale in targeted areas of focus Returning capital to shareholders Strategic M&A priorities Global expansion U.S. Seniors Pharmacy and physician engagement capabilities Retail capabilities Government risk-based programs 34

35 Cigna and Express Scripts Combination 35

36 The combination is part of the solution Focus on the whole person and overall improvement of total health Expanding our reach Improving affordability Driving stakeholder value through alignment, transparency and choice 36

37 Benefits of the combination Accelerates the Strategies of Both Companies by Driving Deeper Alignment Across Critical Elements of the Healthcare System and Positioning the Combined Company to Deliver Over $50 Billion in Savings 1 Strategic Goal: Through the power of alignment we will be the company to grow and nurture patients and physician relationships How? Unrivaled Predictive Capabilities: We will harness insights to predict health and treatment adherence risks Coordinated Care and Treatment: We will have the reach to coordinate pharmacy, medical and behavioral healthcare and treatment even for the most complex cases Aligned Incentives: We will lead the value-based and outcomes-based reward structure across the healthcare spectrum (e.g. with doctors, pharmacists, drug manufacturers) and will be rewarded based on the value we generate for the benefit of clients and customers Tools Data and Technology: We will have combined medical / pharmacy information for over 100 million customers and flexible technology to share insights from that data in an actionable way Deep Relationships: We will deepen relationships with physicians (through our 500+ collaborative accountable care organizations); pharmacists (through our pharmacy networks); and drug manufacturers (through our supply chain management) Integrated Model: We will have the ability to share information seamlessly across our various businesses to deliver integrated care and support Results Lower Costs: We will be positioned to return over $50 billion of savings to clients and customers per year Better Quality of Care: More gaps in care are closed and customers are able to get the right care and treatment from the right doctor at the right time Increased Customer Satisfaction: More personalized care and choice (including [in site of] care and treatment) Health Plan Clients: Will benefit from additional agnostic, portfolio of services Medical Insurance Health and Wellness Services Aligned Healthcare Providers Pharmacy Mgmt Services Pharma Supply Chain. 1. $50 billion represents the annual savings opportunity in 2021 for the combined Cigna-Express Scripts membership population, assuming the combined company achieves medical/pharmacy trend equal to CPI (Consumer Price Index). 37

38 Addressing the evolving needs of a dynamic healthcare market Deliver Differentiated Financial Results Mid-teens EPS accretion in year 1 Increased 2021 EPS target to $20 - $21 per share Outstanding free cash flow with approximately $6 billion of free cash flow in 2021 Further Improve Affordability Best-in-class medical and pharmacy cost trends Further expand and deepen our collaborative relationships Accelerate value based care with pharmacy Poised for Sustained Growth Expand pharmacy penetration and accelerate MA and PDP growth Broaden employer, health plan and government agency offerings with customized tailored solutions including private label Broaden geographic reach and segment depth to middle market Three Growth Platforms Integrated U.S. Medical Integrated U.S. Services Global Employer and Individual Positioned for Long-term Success Enhanced value based care with leading clinical capabilities Open architecture to adapt to evolving market Significant free cash flow and balance sheet flexibility 38

39 Delivers differentiated financial results and shareholder value Drives Strong EPS Accretion Mid-teens accretion in first full year post-close, excluding any contribution from Express Scripts transitioning clients and excluding revenue synergies Increased 2021 EPS target to $20 $21 Delivers Immediate and Longer-Term Cost Savings Greater than $600 million of retained synergies, primarily administrative Billions of savings for customers and clients fuels further growth Strengthens Growth Profile Improves affordability, expands geographic and customer reach and broadens service offerings Long-term Revenue CAGR target of 6% 8% Delivers strong, sustainable margin profile Maintains Balance Sheet Flexibility Robust free cash flow generation (project approximately $6 billion of free cash flow in 2021) Pro forma debt-to-capitalization of ~49%, projected to return to 30s in months post-close; committed to retaining investment grade debt ratings Additional capital deployment capability beyond debt repayment in Proprietary and Confidential. Do not duplicate or distribute. Use and distribution limited to authorized personnel. 39

40 Investor considerations Strong track record of delivering value Clear forward strategy Strong path for sustained growth Commitment to innovation Value-creating combination with Express Scripts Attractive long-term outlook 40

41 Succeeding for shareholders Long-term average annual growth targets EARNINGS CONTRIBUTION EARNINGS 7% 9% PER SHARE 3% 4% 10% 13% CAPITAL DEPLOYMENT plus additional impact of combination with Express Scripts $20 to $21 EPS by

42 Appendix Reconciliation of GAAP to Non-GAAP Financial Measures (Dollars in millions, except per share amounts) YEAR ENDED 12/31/ /31/ /31/ /31/ /31/2013 EPS (FULLY DILUTED): Shareholders' net income $ Results of guaranteed minimum income benefits (0.76) (0.10) (0.09) Net realized investment losses (gains) 0.09 (0.18) (0.15) (0.11) (0.49) Amortization of other acquired intangible assets Special items (0.08) (0.16) Adjusted income from operations $ YEAR ENDED 12/31/ /31/ /31/ /31/2017 EPS (FULLY DILUTED): Shareholders' net income $ Results of guaranteed minimum income benefits Net realized investment losses (gains) (0.40) (0.15) (0.42) (0.61) Amortization of other acquired intangible assets Special items Adjusted income from operations $

43 All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Life Insurance Company of North America, Cigna Life Insurance Company of New York, Cigna Life Insurance Company of Canada, American Retirement Life Insurance Company, Loyal American Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation and Cigna Dental Health, Inc., or affiliates and contracted companies. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only /18. Some content provided under license.