CI · 10-Q · 2026Q3 · Full report

Margin Drivers

Cigna Group · 2026-11-05 · Importance 36 · Surprise 40

Cigna Healthcare’s third-quarter pre-tax adjusted income from operations increased 15%, and its pre-tax margin rose to 10.2% from 9.7%, with higher net investment income and a lower SG&A expense ratio contributing to the earnings increase. Its nine-month pre-tax adjusted income increased 16% to $3.983 billion, primarily because of an improved margin in U.S. Employer. Cigna Healthcare’s medical care ratio rose 20 basis points to 85.0% for the quarter, mainly reflecting an 80-basis-point increase in U.S. Employer, but declined 20 basis points to 83.1% for the nine months. Evernorth’s pre-tax adjusted income fell 4% in the quarter to $1.829 billion and 1% for the nine months to $4.958 billion, as client- and customer-focused initiatives outweighed growth and operating efficiencies.

Key facts

• Cigna pharmacy and other service costs increased 6% in the third quarter and 8% in the first nine months of 2026, primarily reflecting changes in claims composition in Pharmacy Benefit Services. source
• Cigna medical costs and other benefit expenses increased 8% in the third quarter of 2026, primarily reflecting medical cost increases within Cigna Healthcare. source
• Cigna medical costs and other benefit expenses decreased 5% in the first nine months of 2026, primarily due to the HCSC transaction (-13%), partly offset by medical cost increases within Cigna Healthcare. source
• Cigna Healthcare pre-tax adjusted income from operations increased 15% in the third quarter of 2026, primarily due to higher net investment income (+6%) and a lower SG&A expense ratio (+4%). source
• Cigna Healthcare pre-tax adjusted income from operations increased 16% in the first nine months of 2026, primarily due to an improved margin within the U.S. Employer business. source
• Cigna's unpaid claims and claim expenses liability increased to $4.988 billion at September 30, 2026, from $4.241 billion at December 31, 2025, primarily due to stop loss seasonality. source
• Cigna Healthcare's medical care ratio increased 20 basis points in the third quarter of 2026, primarily due to an 80-basis-point increase in U.S. Employer from business mix, partly offset by a 70-basis-point decrease in Individual and Family Plans. source
• Cigna Healthcare's medical care ratio decreased 20 basis points in the first nine months of 2026, largely due to the HCSC transaction (-70 basis points) and a lower Individual and Family Plans ratio (-30 basis points), partly offset by a higher U.S. Employer ratio (+100 basis points), primarily due to business mix. source