Cigna Corporation

Express Scripts under Evernorth serves over 118 million pharmacy lives under multi-year agreements, including a five-year contract with Centene covering approximately 20 million beneficiaries beginning January 2024. Consolidated revenue grew in each fiscal year from FY2022 through FY2025, including through the 2022 inflation period.

Evernorth Health Services generates roughly 75-80% of consolidated revenue, with Cigna Healthcare comprising most of the remainder, and both segments operate within the healthcare sector with correlated cost pressures. The 2025 sale of the Medicare Advantage business to HCSC further concentrated the portfolio.

Nearly all consolidated revenue is derived from U.S. customers, with the international health solutions segment representing a small fraction of total revenues. The 2025 sale of Medicare Advantage further reduced any diversification offset, leaving the company almost entirely exposed to U.S. healthcare policy and reimbursement dynamics.

The PBM platform processes pharmacy claims with limited incremental cost, and the Centene relationship expanded Evernorth's pharmacy lives from 99 million to 118 million in FY2024 with contained operating expense growth. Healthcare insurance claims, however, scale nearly one-for-one with member volume.

PBM contracts with health plans and employers are multi-year, mission-critical, and embedded in clients' benefits administration infrastructure, providing a durably recurring revenue base. The February 2026 FTC settlement requiring a shift from spread pricing toward cost-plus reimbursement represents a structural change to how Evernorth monetizes the pharmacy benefit.