01—Abstract
Summary
Summary of the 8-K filed April 30, 2026. Cited figures are marked; the original filing is the authoritative source.
The Cigna Group (NYSE: CI) reported first quarter 2026 results on April 30, 2026, showing growth in both GAAP and adjusted earnings and raising its full-year 2026 outlook.
Shareholders' net income rose to $1.7 billiona, or $6.26 per share, from $1.3 billion, or $4.85 per share, a year earlier. Adjusted income from operations increased 12% to $2.1 billion, or $7.79 per share, versus $6.74 in Q1 2025. Total revenues grew 5% to $68.5 billion, driven by Evernorth Health Services, though the divestiture of Medicare businesses to HCSC reduced Cigna Healthcare revenues by 21% year over year.
The quality of earnings growth was mixed by segment. Cigna Healthcare was the primary driver, with adjusted pre-tax income up 18% to $1.51 billionb and its medical care ratio improving to 79.8% from 82.2%, aided largely by the HCSC transaction. Excluding that divestiture, Cigna Healthcare adjusted revenues rose 8%, supported by premium rate increases.
Evernorth Health Services adjusted pre-tax income rose only 2%, with Pharmacy Benefit Services down 28% on expected lower contributions from large clients, partially offset by 20% growth in Specialty and Care Services. Pharmacy customer relationships declined 2% sequentially, while medical customers rose 1%. Management raised its 2026 adjusted EPS outlook to at least $30.35c from $30.25, and raised the Cigna Healthcare pre-tax outlook by $25 million to at least $4.525 billion.
The Evernorth pre-tax outlook was reaffirmed at at least $6.9 billiond, and the Cigna Healthcare MCR outlook is 83.7% to 84.7%. The debt-to-capitalization ratio improved to 42.3% from 43.0% at year-end 2025, and the SG&A expense ratio fell to 5.4% from 6.4%. Investors should note that the guidance excludes future acquisitions and that a meaningful portion of year-over-year improvement reflects portfolio changes rather than organic growth.
02—Key points
Key Highlights
- Shareholders' net income of $1.65 billion ($6.26/share) vs. $1.32 billion ($4.85/share) in Q1 2025, up roughly 29% on a per-share basis
- Adjusted income from operations of $2.06 billion ($7.79/share), up 12% from $6.74/share, with total revenues up 5% to $68.5 billion
- 2026 adjusted EPS outlook raised to at least $30.35 (+$0.10); Cigna Healthcare pre-tax outlook raised $25 million to at least $4.525 billion
- Cigna Healthcare MCR improved to 79.8% from 82.2%, largely due to the HCSC Medicare divestiture; ex-divestiture adjusted revenues grew 8%
- Pharmacy Benefit Services adjusted pre-tax income fell 28% on expected lower contributions from large clients, while Specialty and Care Services grew 20%
- Total customer relationships fell 2% to 185.5 million, reflecting pharmacy client transitions, while medical customers rose 1% to 18.3 million
- SG&A expense ratio improved to 5.4% (GAAP) from 6.4%, and debt-to-capitalization declined to 42.3% from 43.0% at year-end 2025
03—Questions
Frequently Asked Questions
Why did Cigna Healthcare adjusted revenues fall 21% while its profitability improved?
The decline reflects the March 19, 2025 divestiture of Cigna's Medicare Advantage, Medicare stand-alone prescription drug plans, and related businesses to HCSC, which contributed $3.85 billion of Q1 2025 revenue. Excluding that transaction, Cigna Healthcare revenues rose 8%, driven by premium rate increases. Margin improvement came from better U.S. Healthcare margins across employer and individual/family plan businesses, and the divested Medicare business had lower margins.
Why did Pharmacy Benefit Services profit decline despite 11% revenue growth?
Management attributed the 28% drop in PBS adjusted pre-tax income to expected lower contributions from large client relationships, which were previously communicated. Revenue growth was primarily driven by drug mix, which does not necessarily carry proportional profit, so investors should watch whether PBS earnings stabilize in future quarters.
How much of the EPS growth is organic versus driven by share count reduction?
Weighted average shares fell to 264.0 million from 273.0 million a year earlier, about a 3% reduction, which contributed to per-share growth. Adjusted income from operations rose about 12% in dollar terms ($1.84 billion to $2.06 billion), and per-share growth of about 16% (from $6.74 to $7.79) reflects both higher earnings and the lower share count from repurchases.
What is driving the change in the 2026 outlook and what risks remain?
The outlook was raised modestly to at least $30.35 per share, with the Cigna Healthcare segment increased by $25 million and the Evernorth segment reaffirmed at at least $6.9 billion. The outlook includes expected share repurchases and dividends but excludes future acquisitions. Key risks include continued pharmacy client attrition, PBS margin pressure, medical cost trends, and the uncertain sustainability of MCR improvements that were partly attributable to the HCSC divestiture.
04—Continue