Cigna Corporation (CI): Modelo de Negócios Canvas [Jan-2025 Atualizado]

No cenário dinâmico do seguro de saúde, a Cigna Corporation (CI) surge como uma potência transformadora, navegando estrategicamente desafios complexos de mercado por meio de sua inovadora tela de modelo de negócios. Ao integrar perfeitamente a tecnologia avançada, soluções abrangentes de saúde e uma abordagem centrada no cliente, a CIGNA se posicionou como uma força pioneira que transcende os limites tradicionais de seguro. Essa exploração revela os intrincados mecanismos que impulsionam o sucesso de Cigna, revelando como a empresa aproveita parcerias estratégicas, plataformas digitais de ponta e experiências personalizadas de saúde para redefinir o ecossistema de seguros.

Cigna Corporation (CI) - Modelo de Negócios: Principais Parcerias

Provedores de saúde e redes médicas

A CIGNA colabora com 1,5 milhão de prestadores de serviços de saúde em todo o mundo. A rede inclui:

Tipo de provedor	Número de provedores
Médicos	750,000
Hospitais	6,500
Especialistas	350,000

Gerentes de benefícios farmacêuticos

A subsidiária de gerenciamento de benefícios de farmácia da Cigna, Scripts Express, gerencia:

• 2 bilhões de reivindicações de prescrição anualmente
• US $ 100 bilhões em gastos anuais de farmácia
• Parcerias com 68.000 farmácias de varejo

Parceiros de tecnologia e saúde digital

Cigna investe em parcerias de saúde digital com:

Categoria de parceiro	Número de parcerias
Plataformas de telessaúde	12
Soluções de saúde da IA	7
Empresas de tecnologia vestível	5

Empresas de seguros e resseguros

A capa de parcerias de resseguros de Cigna:

• US $ 25 bilhões em capacidade total de resseguro
• Parcerias com 15 empresas de resseguros globais
• Cobertura nos segmentos de saúde, vida e incapacidade

Programas de saúde do governo

Cigna participa de parcerias de saúde do governo:

Tipo de programa	Inscrição
Vantagem do Medicare	500.000 membros
Cuidado gerenciado do Medicaid	350.000 membros
Tricare Military Healthcare	250.000 beneficiários

Cigna Corporation (CI) - Modelo de Negócios: Atividades -chave

Seguro de Saúde e Gerenciamento de Cobertura

A CIGNA conseguiu 18,1 milhões de clientes médicos a partir do terceiro trimestre de 2023. A associação médica total atingiu 17,4 milhões em comerciais e 0,7 milhões em segmentos governamentais.

Segmento de seguro	Associação total	Penetração de mercado
Seguro comercial	17,4 milhões	86.5%
Seguro do governo	0,7 milhão	13.5%

Programas de coordenação e bem -estar de cuidados

A Cigna investiu US $ 345 milhões em programas de bem -estar e cuidados preventivos em 2023.

• Programas crônicos de gerenciamento de doenças que cobrem 3,2 milhões de pacientes
• Serviços de telessaúde utilizados por 2,7 milhões de membros
• Programas de apoio à saúde mental que atendem 1,5 milhão de indivíduos

Processamento e administração de reivindicações

Processou 185 milhões de reclamações médicas em 2023, com taxa de precisão de 99,7%.

Categoria de reivindicações	Total de reivindicações	Tempo de processamento
Reivindicações médicas	185 milhões	3,2 dias em média
Reivindicações de farmácia	92 milhões	1,8 dias em média

Desenvolvimento de Tecnologia da Saúde Digital

Investiu US $ 672 milhões em pesquisa e desenvolvimento de tecnologia em saúde digital em 2023.

• Algoritmos de previsão de saúde movidos a IA
• Aplicativos de rastreamento de saúde móvel
• Sistemas de registros eletrônicos de saúde integrados

Gerenciamento de custos médicos e avaliação de risco

Despesas totais de saúde gerenciadas de US $ 78,3 bilhões em 2023.

Categoria de gerenciamento de riscos	Gasto total	Taxa de mitigação de risco
Modelagem preditiva de saúde	US $ 1,2 bilhão	94.5%
Estratégias de contenção de custos	US $ 2,4 bilhões	89.3%

Cigna Corporation (CI) - Modelo de Negócios: Recursos -Principais

Extensa rede de prestadores de serviços de saúde

A partir de 2024, Cigna mantém uma rede de:

Tipo de provedor	Número
Total de prestadores de serviços de saúde	1,5 milhão
Hospitais	7,200
Médicos	345,000
Clínicas	12,500

Recursos avançados de análise de dados

A infraestrutura de análise de dados da Cigna inclui:

• Volume anual de processamento de dados: 500 petabytes
• Modelos de aprendizado de máquina: 250+
• Plataformas de informações sobre saúde em tempo real: 3 sistemas principais

Plataformas de saúde digital e tecnologia

Recurso digital	Métricas
Aplicativos de saúde móvel	8 plataformas ativas
Capacidade de consulta de telessaúde	50.000 consultas virtuais por dia
Investimento em saúde digital	US $ 425 milhões anualmente

Forte infraestrutura financeira

Recursos Financeiros a partir de 2024:

• Total de ativos: US $ 218,3 bilhões
• Receita anual: US $ 86,4 bilhões
• Reservas de caixa: US $ 12,6 bilhões
• Capitalização de mercado: US $ 95,2 bilhões

Profissionais qualificados de saúde e seguros

Categoria profissional	Número
Total de funcionários	70,000
Profissionais de saúde	28,500
Especialistas em seguros	22,000
Profissionais de tecnologia	12,500

Cigna Corporation (CI) - Modelo de Negócios: Proposições de Valor

Soluções abrangentes de seguro de saúde

A CIGNA oferece uma série de planos de seguro de saúde que cobrem 17 milhões de clientes médicos a partir do terceiro trimestre de 2023. O total de membros médicos atingiu 18,1 milhões no mesmo período. A receita anual da Health Insurance Solutions foi de US $ 74,9 bilhões em 2022.

Tipo de plano de seguro	Total de indivíduos cobertos	Prêmio médio anual
Planos individuais	4,2 milhões	$6,328
Planos familiares	8,5 milhões	$15,759
Planos do grupo de empregadores	5,4 milhões	$7,470

Gerenciamento de saúde personalizado

A CIGNA fornece serviços personalizados de gerenciamento de assistência médica a 12,3 milhões de clientes, com o engajamento digital da saúde atingindo 74% em 2022.

• Consultas de telessaúde: 35 milhões de visitas virtuais anuais
• Avaliações de risco para a saúde personalizadas: Concluído para 8,6 milhões de clientes
• Recomendações de saúde orientadas pela IA: Disponível para 65% dos membros

Programas integrados de bem -estar e cuidados preventivos

A participação do programa de bem -estar atingiu 9,2 milhões de indivíduos em 2022, com exames de cuidados preventivos realizados por 6,7 milhões de membros.

Categoria do Programa de Bem -Estar	Participantes	Economia anual de custos
Gerenciamento de doenças crônicas	3,4 milhões	US $ 287 milhões
Apoio à saúde mental	2,8 milhões	US $ 156 milhões
Programas de fitness e nutrição	3 milhões	US $ 214 milhões

Cobertura médica econômica

A taxa média de perda médica da CIGNA foi de 86,4% em 2022, indicando gerenciamento de custos eficientes. Os gastos médios anuais em saúde por membro foram de US $ 5.642.

Experiências de saúde orientadas por tecnologia

O envolvimento da plataforma de saúde digital aumentou para 82% em 2023, com os usuários de aplicativos móveis atingindo 11,5 milhões.

• Downloads de aplicativos de saúde móvel: 4,3 milhões em 2022
• Chatbots de saúde movidos a IA: Disponível para 7,6 milhões de membros
• Rastreamento de saúde em tempo real: usado por 6,9 milhões de indivíduos

Cigna Corporation (CI) - Modelo de Negócios: Relacionamentos do Cliente

Portais de atendimento ao cliente online

A CIGNA opera Mycigna.com, atendendo a 17,4 milhões de usuários digitais ativos a partir do terceiro trimestre de 2023. O portal on -line processa aproximadamente 68% das interações de atendimento ao cliente digitalmente.

Plataforma digital	Métricas de usuário	Interações anuais
mycigna.com	17,4 milhões de usuários ativos	92,3 milhões de interações digitais

Gerenciamento de conta dedicado

A CIGNA fornece gerenciamento de contas especializado para clientes corporativos com mais de 500 funcionários, cobrindo aproximadamente 13,6 milhões de vidas comerciais.

• Segmentos de clientes corporativos com gerentes de conta dedicados
• Tamanho médio da conta: 1.200 funcionários
• Cobertura de gerenciamento de contas: 86% dos contratos de grande grupo

Coaching de saúde personalizado

A CIGNA oferece treinamento personalizado de saúde por meio de 2.300 profissionais de saúde certificados, atendendo 3,2 milhões de indivíduos anualmente.

Serviço de treinamento em saúde	Profissionais	Alcance anual
Coaching de saúde personalizado	2.300 profissionais certificados	3,2 milhões de indivíduos

Suporte ao aplicativo móvel

O aplicativo móvel da Cigna possui 8,6 milhões de usuários mensais ativos, com classificação de satisfação de 92% para experiência digital.

• Usuários mensais de aplicativos móveis ativos: 8,6 milhões
• Taxa de satisfação do aplicativo móvel: 92%
• Principais recursos do aplicativo: rastreamento de reivindicações, acesso à telessaúde, gerenciamento de benefícios

Canais de comunicação direta

A CIGNA mantém vários canais de comunicação direta, lidando com 46,7 milhões de interações com os clientes anualmente nos plataformas de telefone, e -mail e bate -papo.

Canal de comunicação	Interações anuais	Tempo médio de resposta
Suporte telefônico	24,3 milhões de interações	3,2 minutos
Suporte por e -mail	12,4 milhões de interações	6,1 horas
Bate -papo ao vivo	10,0 milhões de interações	45 segundos

Cigna Corporation (CI) - Modelo de Negócios: Canais

Mercado de seguros on -line

A CIGNA opera o Mycigna.com, atendendo a 17,4 milhões de usuários digitais a partir do terceiro trimestre de 2023. A plataforma digital lida com aproximadamente 42% das interações do cliente e solicitações de serviço.

Canal digital	Métricas de usuário
Usuários do site	17,4 milhões
Downloads de aplicativos móveis	3,2 milhões
Interações de serviço digital	42%

Equipe de vendas diretas

A CIGNA mantém uma força de vendas direta de 4.200 representantes de vendas profissionais nos Estados Unidos a partir de 2023. O representante médio de vendas gera receita anual de US $ 2,3 milhões.

Parcerias do grupo de empregadores

A CIGNA atende 190 empresas da Fortune 500 por meio de parcerias do Employer Group. A base total de clientes do grupo de empregadores abrange 44.000 clientes organizacionais.

Categoria de parceria	Número de clientes
Fortune 500 empresas	190
Total de clientes do grupo de empregadores	44,000

Plataformas digitais e aplicativos móveis

Recursos de aplicativos móveis da Cigna:

• 3,2 milhões de downloads totais de aplicativos móveis
• Rastreamento de reivindicações em tempo real
• Capacidades de consulta de telessaúde
• Acesso ao cartão de identificação digital

Corretores de seguros e agentes

A CIGNA colabora com 85.000 corretores e agentes independentes de seguros em todo o país. Esses canais geram aproximadamente 35% do total de vendas anuais de seguros.

Canal de corretor	Métricas
Total de corretores independentes	85,000
Vendas geradas através de corretores	35%

Cigna Corporation (CI) - Modelo de Negócios: Segmentos de Clientes

Empregadores corporativos

A Cigna atende 189 das empresas da Fortune 500 a partir de 2023. A base total de clientes corporativos inclui aproximadamente 16.000 empregadores em todo o país.

Segmento do empregador	Número de clientes	Receita anual
Grandes empresas	1,750	US $ 8,3 bilhões
Empresas de tamanho médio	6,500	US $ 3,6 bilhões
Pequenas empresas	8,250	US $ 1,9 bilhão

Consumidores de seguro de saúde individuais

A CIGNA cobre 17 milhões de consumidores individuais de seguro de saúde nos Estados Unidos.

• Inscrição de mercado individual: 3,2 milhões de membros
• Custo médio do plano individual: US $ 456 por mês
• Taxa de retenção do plano de saúde individual: 82%

Participantes do Medicare e Medicaid

A CIGNA atende 5,4 milhões de participantes do Medicare e Medicaid em 2024.

Programa	Inscrição	Receita premium anual
Vantagem do Medicare	3,1 milhões	US $ 6,7 bilhões
Medicaid	2,3 milhões	US $ 4,2 bilhões

Pequenas e médias empresas

A CIGNA suporta 8.250 empresas pequenas e médias em todo o país.

• Contagem média de funcionários do cliente da SMB: 50-500 funcionários
• Custo médio do plano de saúde anual por SMB: US $ 750.000
• Taxa de crescimento do segmento de mercado de SMB: 6,3%

Segmentos de mercado internacional

A CIGNA opera em 30 países com base internacional de clientes.

Região	Número de países	Clientes internacionais
América do Norte	2	18 milhões
Europa	12	5,6 milhões
Ásia -Pacífico	10	3,4 milhões
Médio Oriente	6	2,1 milhões

Cigna Corporation (CI) - Modelo de Negócios: Estrutura de Custo

Reivindicações e reembolsos de saúde

Em 2023, as despesas totais de reivindicações médicas da Cigna foram de US $ 177,4 bilhões. A quebra dos índices de custo médico inclui:

Categoria	Porcentagem do total de reivindicações	Valor em dólares (bilhões)
Serviços de internação	38%	$67.4
Serviços ambulatoriais	42%	$74.5
Medicamentos prescritos	20%	$35.5

Tecnologia e infraestrutura digital

A Cigna investiu US $ 1,2 bilhão em tecnologia e infraestrutura digital em 2023, com alocações importantes, incluindo:

• Investimentos em computação em nuvem: US $ 350 milhões
• Sistemas de segurança cibernética: US $ 250 milhões
• Plataformas de saúde digital: US $ 300 milhões
• Infraestrutura de análise de dados: US $ 300 milhões

Compensação dos funcionários

A compensação total dos funcionários pela CIGNA em 2023 foi de US $ 12,8 bilhões, estruturada da seguinte maneira:

Tipo de compensação	Valor (bilhões)
Salários da base	$7.2
Bônus de desempenho	$2.5
Remuneração baseada em ações	$1.6
Benefícios e seguro	$1.5

Marketing e aquisição de clientes

As despesas de marketing da CIGNA em 2023 totalizaram US $ 1,8 bilhão, com distribuição entre canais:

• Marketing Digital: US $ 600 milhões
• Publicidade da mídia tradicional: US $ 450 milhões
• Comissões diretas de vendas e corretores: US $ 500 milhões
• Patrocínio de eventos e envolvimento da comunidade: US $ 250 milhões

Despesas de conformidade regulatória

Os custos de conformidade regulatória da CIGNA em 2023 totalizaram US $ 750 milhões, incluindo:

• Equipe legal e de conformidade: US $ 250 milhões
• Sistemas de relatórios regulatórios: US $ 200 milhões
• Taxas externas de auditoria e consultoria: US $ 150 milhões
• Treinamento e educação de conformidade: US $ 150 milhões

Cigna Corporation (CI) - Modelo de negócios: fluxos de receita

Prêmios de seguro de saúde

Em 2023, a CIGNA registrou receita total de US $ 180,6 bilhões, com os prêmios de seguro de saúde constituindo uma parcela significativa dessa receita.

Segmento	Receita Premium (2023)
Seguro de Saúde Comercial	US $ 68,3 bilhões
Seguro de saúde individual	US $ 12,5 bilhões

Contratos do Medicare e Medicaid

A receita do Medicare e do Medicaid da CIGNA para 2023 totalizou US $ 37,2 bilhões.

• Planos de vantagem do Medicare: US $ 24,8 bilhões
• Cuidado gerenciado do Medicaid: US $ 12,4 bilhões

Planos de seguro de grupo corporativo

Os planos de seguro de grupo corporativo geraram US $ 52,6 bilhões em receita para a CIGNA em 2023.

Tipo de plano	Receita
Grandes planos de grupo	US $ 38,4 bilhões
Planos de pequenos grupos	US $ 14,2 bilhões

Serviços de Saúde Suplementares

Os Serviços de Saúde Suplementares contribuíram com US $ 15,7 bilhões para a receita da CIGNA em 2023.

• Serviços odontológicos: US $ 4,3 bilhões
• Cuidado com visão: US $ 3,9 bilhões
• Saúde comportamental: US $ 4,5 bilhões
• Gerenciamento de benefícios de farmácia: US $ 3,0 bilhões

Receitas internacionais de mercado de saúde

As receitas do mercado internacional de saúde da CIGNA atingiram US $ 6,8 bilhões em 2023.

Região	Receita
Ásia -Pacífico	US $ 3,2 bilhões
Médio Oriente	US $ 2,1 bilhões
Outros mercados internacionais	US $ 1,5 bilhão

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.