Cigna Corporation (CI): Lienzo del Modelo de Negocio [Actualizado en Ene-2025]

En el panorama dinámico del seguro de salud, Cigna Corporation (CI) surge como una potencia transformadora, navegando estratégicamente los desafíos del mercado complejos a través de su innovador lienzo de modelo de negocio. Al integrar a la perfección la tecnología avanzada, las soluciones de atención médica integrales y un enfoque centrado en el cliente, Cigna se ha posicionado como una fuerza pionera que trasciende los límites de seguros tradicionales. Esta exploración presenta los intrincados mecanismos que impulsan el éxito de Cigna, revelando cómo la empresa aprovecha las asociaciones estratégicas, las plataformas digitales de vanguardia y las experiencias de atención médica personalizadas para redefinir el ecosistema de seguros.

Cigna Corporation (CI) - Modelo de negocios: asociaciones clave

Proveedores de atención médica y redes médicas

Cigna colabora con 1,5 millones de proveedores de atención médica a nivel mundial. La red incluye:

Tipo de proveedor	Número de proveedores
Médicos	750,000
Hospitales	6,500
Especialistas	350,000

Gerentes de beneficios farmacéuticos

Subsidiaria de gestión de beneficios de farmacia de Cigna, Express scripts, administra:

• 2 mil millones de reclamos recetados anualmente
• $ 100 mil millones en gasto anual de farmacia
• Asociaciones con 68,000 farmacias minoristas

Tecnología y socios de salud digital

Cigna invierte en asociaciones de salud digital con:

Categoría de socio	Número de asociaciones
Plataformas de telesalud	12
AI Soluciones de atención médica	7
Empresas de tecnología portátil	5

Empresas de seguros y reaseguros

Las asociaciones de reaseguros de Cigna cubren:

• $ 25 mil millones en capacidad de reaseguro total
• Asociaciones con 15 firmas de reaseguro global
• Cobertura a través de segmentos de salud, vida y discapacidad

Programas de atención médica del gobierno

Cigna participa en asociaciones de atención médica del gobierno:

Tipo de programa	Inscripción
Ventaja de Medicare	500,000 miembros
Atención administrada de Medicaid	350,000 miembros
TRICARE MILICID SALUDAY	250,000 beneficiarios

Cigna Corporation (CI) - Modelo de negocio: actividades clave

Seguro de salud y gestión de cobertura

Cigna administró 18.1 millones de clientes médicos a partir del tercer trimestre de 2023. La membresía médica total alcanzó los 17.4 millones en comerciales y 0.7 millones en segmentos gubernamentales.

Segmento de seguro	Membresía total	Penetración del mercado
Seguro comercial	17.4 millones	86.5%
Seguro del gobierno	0.7 millones	13.5%

Programas de coordinación y bienestar de la atención

Cigna invirtió $ 345 millones en programas de bienestar y atención preventiva en 2023.

• Programas de manejo de enfermedades crónicas que cubren 3,2 millones de pacientes
• Servicios de telesalud utilizados por 2.7 millones de miembros
• Programas de apoyo de salud mental que atienden a 1,5 millones de personas

Procesamiento y administración de reclamos

Procesó 185 millones de reclamos médicos en 2023 con una tasa de precisión del 99.7%.

Categoría de reclamos	Reclamaciones totales	Tiempo de procesamiento
Reclamos médicos	185 millones	Promedio de 3.2 días
Reclamos de farmacia	92 millones	1,8 días promedio

Desarrollo de tecnología de salud digital

Invirtió $ 672 millones en investigación y desarrollo de tecnología de salud digital en 2023.

• Algoritmos de predicción de salud con IA
• Aplicaciones de seguimiento de salud móvil
• Sistemas de registros de salud electrónicos integrados

Gestión de costos médicos y evaluación de riesgos

Gastos de salud totales administrados de $ 78.3 mil millones en 2023.

Categoría de gestión de riesgos	Gasto total	Tasa de mitigación de riesgos
Modelado de atención médica predictiva	$ 1.2 mil millones	94.5%
Estrategias de contención de costos	$ 2.4 mil millones	89.3%

Cigna Corporation (CI) - Modelo de negocio: recursos clave

Extensa red de proveedores de atención médica

A partir de 2024, Cigna mantiene una red de:

Tipo de proveedor	Número
Proveedores de atención médica totales	1.5 millones
Hospitales	7,200
Médicos	345,000
Clínicas	12,500

Capacidades de análisis de datos avanzados

La infraestructura de análisis de datos de Cigna incluye:

• Volumen de procesamiento de datos anual: 500 petabytes
• Modelos de aprendizaje automático: 250+
• Plataformas de Insights de salud en tiempo real: 3 sistemas principales

Plataformas y tecnología de salud digital

Recurso digital	Métrica
Aplicaciones de salud móvil	8 plataformas activas
Capacidad de consulta de telesalud	50,000 consultas virtuales por día
Inversión en salud digital	$ 425 millones anuales

Infraestructura financiera fuerte

Recursos financieros a partir de 2024:

• Activos totales: $ 218.3 mil millones
• Ingresos anuales: $ 86.4 mil millones
• Reservas de efectivo: $ 12.6 mil millones
• Capitalización de mercado: $ 95.2 mil millones

Profesionales de atención médica y seguros calificadas

Categoría profesional	Número
Total de empleados	70,000
Profesionales de la salud	28,500
Especialistas en seguros	22,000
Profesionales de la tecnología	12,500

Cigna Corporation (CI) - Modelo de negocio: propuestas de valor

Soluciones integrales de seguro de salud

Cigna ofrece una gama de planes de seguro de salud que cubren 17 millones de clientes médicos a partir del tercer trimestre de 2023. La membresía total del cliente médico alcanzó los 18.1 millones en el mismo período. Los ingresos anuales de las soluciones de seguro de salud fueron de $ 74.9 mil millones en 2022.

Tipo de plan de seguro	Total de individuos cubiertos	Prima anual promedio
Planes individuales	4.2 millones	$6,328
Planes familiares	8.5 millones	$15,759
Planes grupales de empleadores	5.4 millones	$7,470

Gestión de atención médica personalizada

CIGNA ofrece servicios personalizados de gestión de salud a 12.3 millones de clientes, con un compromiso de salud digital que alcanza el 74% en 2022.

• Consultas de telesalud: 35 millones de visitas virtuales anuales
• Evaluaciones personalizadas de riesgos para la salud: completado para 8.6 millones de clientes
• Recomendaciones de salud impulsadas por IA: Disponible para el 65% de los miembros

Programas integrados de bienestar y atención preventiva

La participación del programa de bienestar llegó a 9.2 millones de personas en 2022, con exámenes de atención preventiva realizada para 6.7 millones de miembros.

Categoría del programa de bienestar	Participantes	Ahorro anual de costos
Manejo de enfermedades crónicas	3.4 millones	$ 287 millones
Apoyo de salud mental	2.8 millones	$ 156 millones
Programas de fitness y nutrición	3 millones	$ 214 millones

Cobertura médica rentable

La relación promedio de pérdida médica de Cigna fue del 86.4% en 2022, lo que indica una gestión eficiente de costos. El gasto promedio de atención médica anual por miembro fue de $ 5,642.

Experiencias de atención médica impulsadas por la tecnología

La participación de la plataforma de salud digital aumentó al 82% en 2023, con los usuarios de aplicaciones móviles que alcanzan los 11.5 millones.

• Descargas de aplicaciones de salud móvil: 4.3 millones en 2022
• Chatbots de salud con IA: disponible para 7.6 millones de miembros
• Seguimiento de salud en tiempo real: utilizado por 6.9 millones de personas

Cigna Corporation (CI) - Modelo de negocio: relaciones con los clientes

Portales de servicio al cliente en línea

Cigna opera mycigna.com, atendiendo a 17.4 millones de usuarios digitales activos a partir del tercer trimestre de 2023. El portal en línea procesa aproximadamente el 68% de las interacciones de servicio al cliente digitalmente.

Plataforma digital	Métricas de usuario	Interacciones anuales
mycigna.com	17.4 millones de usuarios activos	92.3 millones de interacciones digitales

Gestión de cuentas dedicada

CIGNA ofrece una gestión de cuentas especializada para clientes empresariales con más de 500 empleados, que cubre aproximadamente 13,6 millones de vidas comerciales.

• Segmentos de clientes empresariales con gerentes de cuentas dedicados
• Tamaño promedio de la cuenta: 1.200 empleados
• Cobertura de gestión de cuentas: 86% de los contratos de grupos grandes

Coaching de salud personalizado

CIGNA ofrece coaching de salud personalizado a 2.300 profesionales de la salud certificados, atendiendo a 3,2 millones de personas anualmente.

Servicio de coaching de salud	Profesionales	Alcance anual
Coaching de salud personalizado	2.300 profesionales certificados	3.2 millones de personas

Soporte de aplicaciones móviles

La aplicación móvil de Cigna tiene 8.6 millones de usuarios mensuales activos, con una calificación de satisfacción del 92% para la experiencia digital.

• Usuarios mensuales de aplicaciones móviles activas: 8.6 millones
• Tasa de satisfacción de la aplicación móvil: 92%
• Características clave de la aplicación: seguimiento de reclamos, acceso a telesalud, gestión de beneficios

Canales de comunicación directa

Cigna mantiene múltiples canales de comunicación directa, manejando 46.7 millones de interacciones de clientes anualmente en plataformas de teléfono, correo electrónico y chat.

Canal de comunicación	Interacciones anuales	Tiempo de respuesta promedio
Soporte telefónico	24.3 millones de interacciones	3.2 minutos
Soporte por correo electrónico	12,4 millones de interacciones	6.1 horas
Chat en vivo	10.0 millones de interacciones	45 segundos

Cigna Corporation (CI) - Modelo de negocios: canales

Mercado de seguros en línea

Cigna opera mycigna.com, atendiendo a 17.4 millones de usuarios digitales a partir del tercer trimestre de 2023. La plataforma digital maneja aproximadamente el 42% de las interacciones y las solicitudes de servicio del cliente.

Canal digital	Métricas de usuario
Usuarios del sitio web	17.4 millones
Descargas de aplicaciones móviles	3.2 millones
Interacciones de servicio digital	42%

Equipo de ventas directas

Cigna mantiene una fuerza de ventas directa de 4.200 representantes de ventas profesionales en los Estados Unidos a partir de 2023. El representante promedio de ventas genera $ 2.3 millones de ingresos anuales.

Asociaciones del grupo de empleadores

Cigna atiende a 190 compañías Fortune 500 a través de asociaciones de empleadores. La base de clientes de Total Employer Group abarca 44,000 clientes organizacionales.

Categoría de asociación	Número de clientes
Fortune 500 Companies	190
Total de los clientes del grupo de empleadores	44,000

Plataformas digitales y aplicaciones móviles

Características de la aplicación móvil de Cigna:

• 3.2 millones de descargas de aplicaciones móviles totales
• Seguimiento de reclamos en tiempo real
• Capacidades de consulta de telesalud
• Acceso a la tarjeta de identificación digital

Corredores de seguro y agentes

Cigna colabora con 85,000 corredores y agentes de seguros independientes en todo el país. Estos canales generan aproximadamente el 35% de las ventas de seguros anuales totales.

Canal de corredores	Métrica
Corredores independientes totales	85,000
Ventas generadas a través de corredores	35%

Cigna Corporation (CI) - Modelo de negocio: segmentos de clientes

Empleadores corporativos

Cigna sirve a 189 de las compañías Fortune 500 a partir de 2023. La base total de clientes corporativos incluye aproximadamente 16,000 empleadores en todo el país.

Segmento del empleador	Número de clientes	Ingresos anuales
Grandes empresas	1,750	$ 8.3 mil millones
Empresas de tamaño mediano	6,500	$ 3.6 mil millones
Pequeñas empresas	8,250	$ 1.9 mil millones

Consumidores individuales de seguros de salud

Cigna cubre a 17 millones de consumidores individuales de seguros de salud en los Estados Unidos.

• Inscripción de mercado individual: 3.2 millones de miembros
• Costo promedio del plan individual: $ 456 por mes
• Tasa de retención del plan de salud individual: 82%

Participantes de Medicare y Medicaid

Cigna atiende a 5,4 millones de participantes de Medicare y Medicaid en 2024.

Programa	Inscripción	Ingresos anuales de prima
Ventaja de Medicare	3.1 millones	$ 6.7 mil millones
Seguro de enfermedad	2.3 millones	$ 4.2 mil millones

Pequeñas y medianas empresas

Cigna admite 8.250 empresas pequeñas y medianas en todo el país.

• SMB cliente promedio de empleados Recuento: 50-500 empleados
• Costo promedio de plan de salud anual por SMB: $ 750,000
• Tasa de crecimiento del segmento de mercado de SMB: 6.3%

Segmentos del mercado internacional

Cigna opera en 30 países con base de clientes internacionales.

Región	Número de países	Clientes internacionales
América del norte	2	18 millones
Europa	12	5.6 millones
Asia Pacífico	10	3.4 millones
Oriente Medio	6	2.1 millones

Cigna Corporation (CI) - Modelo de negocio: Estructura de costos

Reclamaciones y reembolsos de atención médica

En 2023, los gastos totales de reclamos médicos de Cigna fueron de $ 177.4 mil millones. El desglose de las proporciones de costos médicos incluye:

Categoría	Porcentaje de reclamos totales	Monto en dólares (miles de millones)
Servicios para pacientes hospitalizados	38%	$67.4
Servicios ambulatorios	42%	$74.5
Medicamentos recetados	20%	$35.5

Tecnología e infraestructura digital

Cigna invirtió $ 1.2 mil millones en tecnología e infraestructura digital en 2023, con asignaciones clave que incluyen:

• Inversiones de computación en la nube: $ 350 millones
• Sistemas de ciberseguridad: $ 250 millones
• Plataformas de salud digital: $ 300 millones
• Infraestructura de análisis de datos: $ 300 millones

Compensación de empleados

La compensación total de los empleados para Cigna en 2023 fue de $ 12.8 mil millones, estructurada de la siguiente manera:

Tipo de compensación	Cantidad (miles de millones)
Salarios base	$7.2
Bonos de rendimiento	$2.5
Compensación basada en acciones	$1.6
Beneficios y seguro	$1.5

Marketing y adquisición de clientes

Los gastos de marketing para Cigna en 2023 totalizaron $ 1.8 mil millones, con distribución en todos los canales:

• Marketing digital: $ 600 millones
• Publicidad de medios tradicional: $ 450 millones
• Ventas directas y comisiones de corredores: $ 500 millones
• Patrocinios de eventos y participación comunitaria: $ 250 millones

Gastos de cumplimiento regulatorio

Los costos de cumplimiento regulatorio de Cigna en 2023 ascendieron a $ 750 millones, incluidos:

• Personal legal y de cumplimiento: $ 250 millones
• Sistemas de informes regulatorios: $ 200 millones
• Tarifas de auditoría y consultoría externa: $ 150 millones
• Capacitación y educación de cumplimiento: $ 150 millones

Cigna Corporation (CI) - Modelo de negocios: flujos de ingresos

Primas de seguro de salud

En 2023, Cigna reportó ingresos totales de $ 180.6 mil millones, con primas de seguro de salud que constituyen una parte significativa de estos ingresos.

Segmento	Ingresos premium (2023)
Seguro de salud comercial	$ 68.3 mil millones
Seguro de salud individual	$ 12.5 mil millones

Contratos de Medicare y Medicaid

Los ingresos de Cigna en Medicare y Medicaid para 2023 totalizaron $ 37.2 mil millones.

• Planes de Medicare Advantage: $ 24.8 mil millones
• Atención administrada de Medicaid: $ 12.4 mil millones

Planes de seguro del grupo corporativo

Los planes de seguro grupal corporativo generaron $ 52.6 mil millones en ingresos para CIGNA en 2023.

Tipo de plan	Ganancia
Planes grupales grandes	$ 38.4 mil millones
Planes grupales pequeños	$ 14.2 mil millones

Servicios de salud suplementarios

Supplemental Health Services contribuyó con $ 15.7 mil millones a los ingresos de Cigna en 2023.

• Servicios dentales: $ 4.3 mil millones
• Vision Care: $ 3.9 mil millones
• Salud del comportamiento: $ 4.5 mil millones
• Gestión de beneficios de farmacia: $ 3.0 mil millones

Ingresos del mercado internacional de la salud

Los ingresos del mercado internacional de salud de Cigna alcanzaron los $ 6.8 mil millones en 2023.

Región	Ganancia
Asia Pacífico	$ 3.2 mil millones
Oriente Medio	$ 2.1 mil millones
Otros mercados internacionales	$ 1.5 mil millones

Cigna Corporation (CI) - Canvas Business Model: Value Propositions

You're looking at how Cigna Corporation delivers value, and honestly, it's all about the integration between Cigna Healthcare and the powerhouse that is Evernorth Health Services. This dual-engine approach is what sets their value proposition apart in late 2025.

For employers, the core value is the seamless combination of medical coverage and pharmacy benefits management (PBM). The Evernorth segment, which includes specialty and care services, is clearly driving the top line. For the third quarter of 2025, total revenue hit $69.75 billion, a 9.5% jump year-over-year, largely due to Evernorth's performance. The adjusted revenue in Evernorth specifically surged by 15% in Q3 2025. This integrated model helps control costs across the entire patient journey.

Cost predictability comes directly from Evernorth's PBM model, especially through aggressive management of high-cost specialty drugs. They are actively converting members to lower-cost alternatives. For instance, the Humira biosimilar conversion is reportedly running ahead of schedule, with 25% of Accredo patients already using it.

Here's a look at the specific drug cost management value proposition:

• Access to an interchangeable Stelara biosimilar at $0 out-of-pocket cost for eligible members starting early 2025.
• The biosimilar price represents a discount of more than 80% compared to Stelara's list price.
• Expected annual savings for individual patients utilizing this program is about $4,000 on average.
• This drug cost initiative targets over 30,000 Accredo patients currently on Stelara.

The company is also heavily investing in simplifying the customer experience, which is a huge value-add when you consider research shows only 20% of U.S. adults feel confident understanding their health insurance benefits. Cigna Healthcare announced an investment of up to $150 million in improving customer experience in January 2025.

The new AI-powered digital tools offer concrete benefits:

Digital Tool/Metric	Reported Data/Statistic
AI-Powered Virtual Assistant Adoption (Early)	67%
AI-Powered Virtual Assistant Satisfaction (Early)	80% found it helpful
Real-Time Cost Tracking Feature	Provides breakdown of deductibles, out-of-pocket costs, and bill payments
Smart Claim Submission	Auto-fills claim details after user uploads a bill

For clients with globally mobile workforces, Cigna Global provides extensive reach. While the outline mentioned more than 30 jurisdictions, the actual network scope is much wider, offering comprehensive support.

• Global health coverage is available in more than 200 countries and jurisdictions.
• The global network includes over 1.65 million hospitals, clinics, and medical professionals.
• Cigna serves over 182.5 million customer relationships globally as of late 2025.

Finance: draft updated Evernorth segment growth forecast for Q4 2025 by next Tuesday.

Cigna Corporation (CI) - Canvas Business Model: Customer Relationships

You're looking at how Cigna Corporation (CI) builds and maintains its relationships with its massive customer base as of late 2025. This isn't just about sending out ID cards; it's a multi-pronged approach blending high-touch human support with scalable digital tools, all under a new mandate for transparency.

Dedicated Patient Advocates for Complex Health Needs (My Personal Champions)

For members facing the toughest health battles, Cigna Healthcare is doubling down on personalized support. They are actively expanding the team of My Personal Champion advocates specifically to help those with serious conditions like cancer, stroke, or heart attack navigate the maze of care and administration. This expansion is a direct response to the complexity members face when dealing with multiple clinicians and pharmacies.

• Cigna Healthcare is doubling the number of My Personal Champion advocates.
• Advocates assist with unique and complex clinical, situational, or administrative needs.
• Investment is also going into new concierge teams to help resolve prior authorization and claims payment challenges directly with the customer's physician.

High-Touch, Consultative Relationships with Large Employer Clients and Brokers

For your large corporate clients, the relationship is consultative, focusing on managing the health plan's performance and cost structure. While we don't have specific client retention percentages for 2025, Cigna noted success in maintaining its base despite market pressures. For instance, after seeing an expected high level of claims in employer-sponsored health plans in the first quarter of 2025, Cigna increased stop-loss prices for 2025, yet Brian Evanko, the chief operating officer, noted they executed this while preserving their typical client retention levels. This suggests the consultative value proposition is holding firm.

Here's a snapshot of the scale and some related operational data as of mid-2025:

Metric	Value as of June 30, 2025	Context
Total Customer Relationships	182.2 million	Global relationships across all segments.
Total Pharmacy Customers	121.9 million	Increased 3% from December 31, 2024.
Cigna Healthcare Medical Customers	18.0 million	Reflecting impact of HCSC transaction.

Digital Self-Service via the myCigna App and AI-Powered Virtual Assistant

The digital relationship is where Cigna is seeing clear, measurable wins. The myCigna mobile app gives members one-touch access to digital ID cards, deductible balances, and recent claims. The focus is clearly on making digital interactions as good as, or better than, other industries you use daily, like financial services. Early data on the AI virtual assistant is quite positive; honestly, it's a strong indicator of digital adoption success.

The digital experience is being benchmarked against competitors, and Cigna Healthcare is leading in one key area:

• Early data shows that four out of five customers who used the virtual assistant found it helpful.
• Cigna Healthcare ranked highest in satisfaction among commercial member health plans with a score of 683 in the 2025 J.D. Power U.S. Healthcare Digital Experience Study.
• Satisfaction with mobile apps generally is highest (score of 636) compared to websites (607) or phone support (607) for commercial members.

Multi-Year Journey Toward Greater Transparency, Including a 2026 Consumer Transparency Report

Accountability is now being baked into leadership incentives; executive compensation is tied to improving customer satisfaction scores. This commitment culminates in a public report. You can expect the first official report detailing 2025 impact and results in early 2026. This isn't just PR; it's a structural change to how Cigna reports on its operations.

The transparency effort includes specific operational metrics they plan to share:

• Publishing an annual Consumer Transparency Report starting in early 2026.
• Report will detail progress on commitments, including information on customer care, services, and resolution statistics.
• Executive compensation is tied to improving customer satisfaction.

Personalized Plan Selection Support for Employer-Sponsored Open Enrollment

For employer groups, the annual open enrollment period is critical for member satisfaction. For plans effective January 1, 2026, the standard Open Enrollment Period runs from November 1-December 15, 2025, in most states. Cigna is using its digital tools to make this process less painful. The myCigna app offers specific support here, helping employees compare prices, search for providers, and estimate their potential healthcare costs before making a final selection. This moves the relationship from reactive claims processing to proactive decision support.

The digital tools are designed to simplify the enrollment decision:

Digital Support Feature	Functionality during Open Enrollment
myCigna App Support	Helps compare prices for plan selection.
myCigna App Support	Allows users to search for in-network providers.
myCigna App Support	Enables estimation of possible healthcare costs.

Finance: draft 13-week cash view by Friday.

Cigna Corporation (CI) - Canvas Business Model: Channels

You're mapping out Cigna Corporation's distribution strategy as of late 2025, focusing on how they get their products and services to the customer. This is where the rubber meets the road for their commercial and individual segments, heavily supported by the Evernorth health services engine.

Direct sales teams targeting large and mid-sized employers remain a core channel for Cigna Healthcare's commercial business. These teams manage the relationship for fully insured and self-funded employer groups, selling comprehensive medical, pharmacy, and ancillary benefits directly to plan sponsors. This channel is crucial for maintaining the core medical customer base, which stood at 18.0 million as of June 30, 2025, though this number reflects the divestiture of Medicare businesses.

The company also relies on a national network of independent insurance brokers and consultants. These intermediaries are essential for reaching the broader middle-market and small-group segments, as well as for advising large employers. Their sales efforts are critical for driving new premium volume, which contributed to Cigna Group's first-quarter 2025 revenue of $65.5 billion.

Digital interaction points are increasingly important for service and prescription fulfillment. The myCigna web portal and mobile application serve as the primary digital interface for members. For instance, customers use these platforms to set up home delivery from Express Scripts Pharmacy. This digital engagement supports the overall health services strategy, where Evernorth Health Services, which includes Express Scripts, drove revenue growth in Q1 2025.

The pharmacy fulfillment network is a massive channel, primarily managed through Evernorth. This includes the retail pharmacy network and the Express Scripts mail-order/specialty pharmacies. Cigna Healthcare Medicare plans contract with major retail chains, and for 2025, they maintain a list of Preferred Network Retail Pharmacies, including chains like Walgreens, CVS/Duane Reade, and grocery store pharmacies. The mail-order and specialty components are handled by Express Scripts Pharmacy and Accredo, respectively. The total pharmacy customer base reached 121.9 million at June 30, 2025, a 3% increase from the end of 2024. Accredo, the specialty pharmacy arm, saw its adjusted revenues increase 13% year-over-year in Q2 2025, signaling strong utilization of this specialized fulfillment channel.

For the individual market, Cigna Healthcare uses the Individual ACA Marketplace as a distinct channel. For 2025 coverage, Cigna Healthcare offers its Individual and Family Medical Plans in 11 states. This channel is supported by specific value propositions designed to attract enrollees, such as capping insulin costs at no more than $25 for a 30-day supply.

Here's a quick look at the scale of the customer base supporting these channels as of mid-2025:

Metric	Value (as of June 30, 2025)	Change from Dec 31, 2024
Total Customer Relationships	182.2 million	N/A
Total Pharmacy Customers	121.9 million	Up 3%
Total Medical Customers (Post-Divestiture)	18.0 million	Down 6% (due to HCSC transaction)

The digital and pharmacy channels are deeply intertwined, especially for maintenance medications, where users are often encouraged to use the home delivery option for up to a 90-day supply. This drives efficiency for Express Scripts, which is a major profit center for the Evernorth division.

The ACA Marketplace participation in 11 states-including Texas, Florida, and North Carolina-is a deliberate strategy to serve specific geographies where Cigna Healthcare believes it has network strength.

• States with 2025 Individual Medical Plans include: Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas, and Virginia.
• Virtual care access is a key feature for these marketplace members, offering 24/7 access to virtual medical and mental health care.

The sales and account management teams supporting the employer channel negotiate contracts and work with clients on strategies that help manage the Medical Cost Ratio, which for Cigna Healthcare was 83.2% in Q2 2025. Finance: draft 13-week cash view by Friday.

Cigna Corporation (CI) - Canvas Business Model: Customer Segments

You're looking at the customer base for Cigna Corporation as of late 2025. It's a mix, heavily leaning on large-scale service contracts through Evernorth Health Services, while the core insurance business focuses on specific employer groups following the strategic exit from Medicare Advantage.

Overall, Cigna Corporation maintained a massive global footprint. As of June 30, 2025, the total customer relationships stood at 182.2 million globally. This number reflects a deliberate portfolio shift, especially after the divestiture of Medicare businesses to Health Care Service Corporation (HCSC).

Here is a breakdown of the key customer segments Cigna Corporation serves, with the latest available metrics:

The primary customer groups are served through two main operating divisions: Cigna Healthcare (insurance/medical plans) and Evernorth Health Services (pharmacy and care services).

Customer Segment Category	Primary Cigna Entity Serving	Key Metric (as of June 30, 2025, unless noted)	Latest Reported Revenue/Volume Data
US Commercial Employers (Large/Mid-sized)	Cigna Healthcare (U.S. Healthcare)	U.S. Healthcare Medical Customers: 16,355 thousand	Cigna Healthcare Segment Projected Full Year 2025 Pre-Tax Operating Income: At least $4.13 billion
Managed Care Orgs & Other Health Insurers (Evernorth Clients)	Evernorth Health Services	Total Pharmacy Customers: 121.9 million	Evernorth Health Services Q3 2025 Adjusted Revenue: $60.39 billion
Individuals & Families (ACA Marketplace)	Cigna Healthcare (IFPs)	Membership significantly reduced; context suggests under 400,000 in early 2025	Total Medical Customers (all lines, post-divestiture): 18.0 million
Global Expatriates & International Orgs	Cigna Healthcare (International Markets)	International Health Medical Customers: 1,691 thousand	Cigna maintains sales capabilities in more than 30 markets and jurisdictions
Government Entities (e.g., DoD)	Cigna Healthcare / Evernorth	Specific contract size not quantified in recent reports; focus shifted away from Medicare Advantage	Evernorth Pharmacy Benefit Services Q3 2025 Adjusted Revenue: $34.09 billion

The employer segment, which Cigna Healthcare focuses on, is broken down internally into specific size categories for service delivery:

• National Accounts: Employers with 3,000 or more eligible employees.
• Middle Market: Employers with 500 to 2,999 eligible employees.
• Select: Employers with 51 to 499 eligible employees.
• Small: Employers with 2 to 50 eligible employees.

Evernorth Health Services, which serves many of these clients plus external ones, shows significant scale in its service lines, which are critical to the overall business mix. For instance, the Specialty and Care Services unit, which handles complex specialty drugs, posted Q3 2025 adjusted revenue of $26.3 billion.

The company has been actively managing its exposure to government-backed plans, with its total medical customers decreasing by 6% from December 31, 2024, to 18.0 million as of June 30, 2025, primarily due to the HCSC transaction.

Cigna Corporation (CI) - Canvas Business Model: Cost Structure

You're looking at the core expenses Cigna Corporation is managing to deliver its services, and honestly, it's a balancing act between medical inflation and operational efficiency. The cost structure is heavily weighted toward claims, but there's clear evidence of cost control efforts in the administrative side.

Medical Costs and Medical Care Ratio (MCR)

The largest component of Cigna Healthcare's cost structure is the medical claims paid out. For the full year 2025, Cigna Healthcare is projecting its Medical Cost Ratio (MCR) to be in the range of 83.2% to 84.2%. This ratio reflects medical costs as a percentage of premiums for all Cigna Healthcare risk products.

We saw the MCR fluctuate through the year, reflecting these cost pressures:

• Q1 2025 Cigna Healthcare MCR was 82.2%, up from 79.9% in Q1 2024.
• Q2 2025 MCR rose to 83.2%, compared to 82.3% in Q2 2024.
• Q3 2025 MCR reached 84.8%.

Costs Associated with Higher Stop-Loss Medical Claims

A significant driver behind the elevated MCR has been the cost associated with stop-loss medical claims, particularly in the commercial segment. This insurance protects employers with self-insured plans against catastrophic losses.

Here's what happened when stop-loss costs spiked:

• In the prior fourth quarter, the claims-to-premium ratio for stop-loss users was between 90% and 95%, which was 4% to 7% higher than Cigna expected.
• The drivers for this spike included high spending on expensive, injectable specialty drugs and increased inpatient surgery costs for serious conditions.
• Stop-loss insurance represents only about 15% of Cigna's total health coverage business.
• Cigna Healthcare's Q3 2025 MCR increase was attributed to these higher stop-loss medical costs, consistent with prior commentary.

Pharmacy Benefit Costs and Rebate Management

Costs related to pharmacy benefits are managed through Evernorth Health Services, which includes Express Scripts. The total pharmacy customers reached 121.9 million as of June 30, 2025, a 3% increase since the end of 2024. Q3 2025 pharmacy revenues were substantial at $56,054 million.

Cigna is actively changing how it manages drug purchasing costs, moving away from the traditional rebate model:

• The value of drug rebates and other discounts in the industry reached $356 billion last year.
• Cigna announced plans to eliminate prescription drug rebates in many commercial health plans starting in 2027.
• The plan is to replace rebates with upfront discounts, which is expected to lower the monthly cost of brand-name prescriptions by an average of 30% for patients paying the full price.
• A revised reimbursement framework for in-network pharmacies is planned for 2026.

Selling, General, and Administrative (SG&A) Expenses

Cigna has demonstrated significant operational rigor, reflected in its SG&A expense ratio, which covers personnel and technology costs. This ratio improvement suggests cost efficiency is a key focus area.

Here's a look at the SG&A expense ratio performance:

Metric	Q3 2024	Q3 2025	Q2 2024	Q2 2025
SG&A Expense Ratio (GAAP)	5.6%	4.8%	N/A	6.1% (Q2 2024)
Adjusted SG&A Expense Ratio	5.5%	4.6%	N/A	5.1% (Q2 2025)

For Q3 2025, the consolidated Selling, General, and Administrative expenses were $3,362 million against total revenue of $69.7 billion. This reduction in the ratio, compared to the prior year, reflects a business mix shift and operational discipline.

Investment in Digital Transformation and AI Governance Framework

While specific dollar amounts for the AI governance framework investment aren't detailed, the application of digital tools is central to cost control and service delivery. The Healthcare segment is using AI and predictive analytics to refine risk pools and adjust stop-loss pricing in real time. Furthermore, Cigna Healthcare has an AI powered virtual assistant to support operations. Evernorth's digital pharmacy platforms are used to optimize drug claims and utilization reviews, which directly impacts pharmacy benefit costs.

Finance: draft 13-week cash view by Friday.

Cigna Corporation (CI) - Canvas Business Model: Revenue Streams

Cigna Corporation projects total adjusted revenue for the full year 2025 to reach at least $252 billion.

The revenue generation is heavily weighted toward the Evernorth Health Services platform, which continues to drive top-line growth across its specialized service offerings. For context on the current run-rate, here is a look at the reported revenue components from the third quarter of 2025:

Revenue Component	Latest Reported Amount (Q3 2025)
Total Consolidated Revenue	$69.75 billion
Evernorth Health Services Adjusted Revenue	$60.39 billion
Evernorth Specialty & Care Services Adjusted Revenue	$26.3 billion
Evernorth Pharmacy Benefit Services Adjusted Revenues	$34.09 billion
Cigna Healthcare Adjusted Revenues	$10.8 billion (Q2 2025 figure, post-divestiture)

The streams feeding into Cigna Corporation's top line are diverse, reflecting the dual-platform strategy:

• Premiums from fully-insured commercial health plans: Fourth quarter 2024 premiums totaled $11.50 billion.
• Fees for administrative services only (ASO) from self-funded employers: These fees are embedded within the Cigna Healthcare segment's revenue, which saw adjusted revenues of $10.8 billion in the second quarter of 2025, excluding the divested Medicare business.
• Pharmacy benefit management (PBM) fees and retained rebates from Evernorth: This is a primary component of the Pharmacy Benefit Services (PBS) adjusted revenue, which reached $34.09 billion in the third quarter of 2025.
• Specialty pharmacy and care services revenue, a key growth driver: Adjusted revenues for Specialty & Care Services were $26.3 billion in the third quarter of 2025.

The company's total medical customer base was reported at 18.1 million members as of the third quarter of 2025.