Cigna Group (CI) Risk Factor Changes

The collectability of amounts due from reinsurers is subject to uncertainty arising from a number of factors, including whether the insured losses meet the qualifying conditions of the reinsurance contract; whether re…

In addition, during and following a prolonged unfavorable economic environment, federal and state budgets could be materially adversely affected, resulting in reduced or delayed reimbursements or payments in governmen…

The covenants in our debt instruments may have the effect of restricting our financial and operating flexibility to respond to significant changes in business and economic conditions, among other things.

The total indebtedness of The Cigna Group was approximately $31.5 billion as of December 31, 2025.

Financial strength, claims-paying ability and debt ratings by recognized rating organizations are each important factors in establishing the competitive position of insurance and health benefits companies.

•deliver discounts to health benefit providers;

•grow and support our product portfolio, expand our addressable markets, develop and effectively implement products and services to improve the accessibility, affordability and transparency of healthcare, and identify…

•the issuance of additional common stock could dilute ownership interests of our shareholders, or the incurrence of additional debt could increase costs and impact our ability to access capital in the future in connec…

•divestitures may result in continued financial exposure, including increased costs due to potential litigation, contingent liabilities, and indemnification of the buyer related to, among other things, lawsuits, regul…

As a global company, our business is increasingly exposed to risks inherent in foreign operations, including challenges arising out from geopolitical conditions, evolving legal and regulatory environment, labor and cu…

Our business is highly dependent upon our ability to perform, in an efficient and uninterrupted fashion, necessary business functions, such as claims processing and payment; the operation of internet support and custo…

Outsourcing also may require us to change our existing operations, adopt new processes for managing these service providers, or redistribute responsibilities to realize the potential productivity and operational effic…

process.

The costs to eliminate or address security threats and vulnerabilities before or after a cyber incident could be significant.

Cybersecurity threats are rapidly evolving, and those threats and the means for obtaining access to our proprietary systems are becoming increasingly sophisticated.

As we increase the amount of PII that we store and share digitally, our exposure to unauthorized uses and disclosures and data privacy and related cybersecurity risks increases, including the risk of undetected attack…

Our business depends on our clients' and customers' willingness to entrust us with their PII, including PHI, that is subject to various privacy and data security laws and regulations, including data breach notificatio…

Any failure or disruption of our performance of, or our ability to perform, key business functions, including through unavailability or cyberattack of our information technology systems or those of third parties (incl…

Our business is highly dependent on maintaining effective information systems, as well as the integrity and timeliness of the data we use to serve our customers and health care providers and to operate our business.

Our business depends on our ability to effectively invest in, improve and properly maintain the uninterrupted operation, availability and data integrity of our information technology and other business systems.

Federal and state governments have made investigating and prosecuting health care and other insurance fraud, waste and abuse a priority.

transaction, we may have indemnification obligations in certain circumstances related to regulatory audits that were ongoing at the time that transaction was completed.

We are frequently the subject of regulatory market conduct and other reviews, audits and investigations by state insurance, health and welfare and pharmacy departments; attorneys general; the DOJ; the FTC; CMS; the DO…

In addition, various government agencies have conducted investigations, inquiries and audits into certain pharmacy benefit management practices, which in certain instances have resulted in litigation or other adverse…

In addition, we are routinely involved in numerous claims, lawsuits, regulatory audits, investigations and other legal matters arising, for the most part, in the ordinary course of business.

Additionally, we are, or may become, subject to U.S.

At the federal level, we are subject to, among other laws and regulations, HIPAA, which requires business associates as well as covered entities to comply with specified privacy and security requirements.

Existing or future laws, regulations, actions by governmental or regulatory authorities, or judgments could force us to change how we conduct our business; affect the products and services we offer and where we offer…

Our business is regulated at the federal, state and international level.

Our business is subject to substantial government regulation, and new laws or regulations or changes in existing laws or regulations could have a material adverse effect on our business, results of operations, financi…

Additionally, if we fail to comply with applicable state or federal regulatory or contractual requirements, including data submission, enrollment and marketing, provider network adequacy, provider directory accuracy,…

Additionally, our products and services, including a broad range of medical, pharmacy, specialty health, and ancillary benefit offerings, are sold in part through non-exclusive producers and consultants for whose serv…

Out-of-network providers for non-Medicare services are not limited by any agreement with us in the amounts they bill.

We contract with or employ physicians, hospitals and other health service providers and facilities to provide health services to our customers and patients.

We maintain and record medical claims reserves in our Consolidated Balance Sheets for estimated future payments.

More than 65,000 pharmacies participated in one or more of our networks as of December 31, 2025.

Our contracts with pharmaceutical manufacturers are typically nonexclusive and terminable on relatively short notice by either party.

Additionally, to succeed in this highly competitive marketplace, we must maintain a strong reputation.

Any significant shifts in the structure of the industry could alter industry dynamics and adversely affect our ability to attract or retain clients and customers.

•new market entrants, including those not traditionally in the health services industry;

We operate in a highly competitive and evolving business environment, and our failure to compete effectively or differentiate our products and services from those of our competitors could materially adversely affect o…

Premiums in the Cigna Healthcare segment are generally set for a one-year period and are priced well in advance of the date on which the contract commences or renews.

Strong competition within the pharmacy benefit business has generated greater demand for lower product and service pricing, increased revenue sharing, and enhanced product and service offerings.

While we compete on the basis of many service- and quality-related factors, we expect that price will continue to be a significant basis of competition.

We must predict, price for and manage health care costs appropriately.

contained in this Form 10-K, including the MD&A.

In addition, provider or customer fraud that is not prevented or detected could impact our medical costs or those of our self-insured clients.

Effective prevention, detection and control systems are critical to maintain regulatory compliance and prevent fraud; failure of these systems could adversely affect us.

and they vary across jurisdictions.

Most of our activities involve the receipt, use, storage or transmission of a substantial amount of individuals' PII, including PHI.

Regulatory audits, investigations, litigation, or reviews or actions by other government agencies have resulted in and could result in changes to our business practices, retroactive adjustments to certain premiums, si…

Many investigations and audits have resulted in companies being subject to civil penalties, including the payment of money and entry into corporate integrity agreements.

The Medicare program has been the subject of regulatory reform initiatives.

Regulators, customers, investors, employees and other stakeholders have focused on environmental, social and governance matters and related disclosures.

We must identify, assess and respond to new trends in the legislative and regulatory environment, as well as comply with the various existing regulations applicable to our business and respond to policymakers and enfo…

each other.

Increasing natural disasters in connection with climate change could also be a direct threat to us and our third-party vendors, service providers or other stakeholders.

Outsourcing also may require us to change our existing operations, adopt new processes for managing these service providers, or redistribute responsibilities to realize the potential productivity and operational effic…

In addition, effective internal controls are necessary to provide reliable and accurate financial reports and to mitigate the risk of fraud.

Strategic transactions could result in increased costs, including facilities and systems consolidation or separation costs and costs to retain key employees, decreases in expected revenues, earnings or cash flows, and…

Our ability to achieve the anticipated benefits of strategic transactions, including synergies, cost savings, innovation and operational efficiencies, is subject to numerous uncertainties and risks, including our abil…

As part of our strategy, we regularly consider and enter into strategic transactions, including mergers, acquisitions, joint ventures, licensing arrangements, divestitures and other relationships (collectively referre…

•general economic and political conditions.

•man-made disasters, natural disasters (including those arising as a result of climate change) and pandemics in locations where we operate; and

•acts of civil unrest, war and terrorism, including the ongoing conflict in the Middle East as well as other political and economic conflicts, such as through imposition of economic or political sanctions;

•the global trend for companies to enact local data residency requirements;

•the provision of data protection on a global basis and sufficient levels of technical support in different locations;

•the management of our partner relationships in countries outside of the United States;

•reliance on local employees and interpretations of labor laws in foreign jurisdictions;

•uncertainty with respect to the adoption of new tax laws and the interpretation of tax positions, such as the European Union's ("EU’s") recent adoption of the Pillar Two directive;

•foreign currency exchange rates and fluctuations and restrictions on converting currencies from foreign operations into other currencies;

•restrictions that prevent us from transferring funds out of the countries in which we operate;

•price controls or other pricing issues and exchange controls, including tariffs;

•regulation that may discriminate against U.S.

•geopolitical business conditions and demands;

As a global company, our business is increasingly exposed to risks inherent in foreign operations.

As a global company, we face political, legal, operational, regulatory, economic and other risks that present challenges and could negatively affect our multinational operations or our long-term growth.

Our use of AI, including ML technologies, as well as more recent technological advances in AI/ML, poses risks to us and subjects us to new and existing laws and regulations.

forums.

•access to limited distribution specialty pharmaceuticals by our specialty pharmacies.

•fees for services provided to pharmaceutical manufacturers by our specialty pharmacies; and

•fees for administering rebate programs, including invoicing, allocating and collecting rebates;

•discounts, in the form of rebates, for drug utilization;

•discounts for drugs we purchase to be dispensed from our home delivery and specialty pharmacies;

We maintain relationships with numerous pharmaceutical manufacturers, which provide us with, among other things:

We maintain and record medical claims reserves in our Consolidated Balance Sheets for estimated future payments.

Premiums in the Cigna Healthcare segment are generally set for one-year periods and are priced well in advance of the date on which the contract commences or renews.

We must remain competitive to attract new customers, retain existing customers and further integrate additional product and service offerings.

Our success depends, in part, on our ability to compete effectively in our markets, set prices appropriately in highly competitive markets to keep or increase our market share, increase customers, differentiate our bu…

We operate in a highly competitive environment and an industry subject to significant market pressures brought about by customer and client needs, legislative and regulatory developments, and other market factors.

•the impact or consequences of legislation, executive actions or regulatory changes;

The health service industry continues to be dynamic and rapidly evolving.

We operate in a highly competitive, evolving and rapidly changing industry, and our failure to adapt could negatively impact our business.

•attract new and maintain existing customer and client relationships;

•attract, develop and maintain collaborative relationships with a sufficient number of qualified partners;

•attract and retain sufficient numbers of qualified employees, particularly in a competitive job market;

•develop and bring to market new and innovative products, solutions or programs that focus on improving patient outcomes and experiences, assist in controlling costs, respond to government regulation or respond to cha…

•differentiate our products, services and solutions from those of our competitors;

The future performance of our business will depend in large part on our ability to effectively implement and execute our strategic and operational initiatives.

supporting our reinsurance recoverable, such as holding sufficient qualifying assets in trusts or letters of credit issued.