Cigna Delivers Strong First Quarter 2019 Results, Raises Outlook

  • Total revenues in the first quarter were $37.9 billion. Adjusted
    revenues
    1 were $33.4 billion.
  • Shareholders’ net income for the first quarter was $1.37 billion,
    or $3.56 per share
  • Adjusted income from operations2 for the
    first quarter was $1.5 billion, or $3.90 per share
  • Adjusted income from operations2,3,4 is
    now projected to be in the range of $6.24 billion to $6.4 billion in
    2019, or $16.25 to $16.65 per share
    3, which
    represents per share growth of 14% to 17% over 2018

BLOOMFIELD, Conn.–(BUSINESS WIRE)–Global health service company Cigna Corporation (NYSE: CI) today
reported strong first quarter 2019 results led by the Health Services
and Integrated Medical segments.

“Cigna’s first quarter performance reflects focused execution of our
proven growth strategy and positions us well to achieve our increased
outlook for 2019,” said David M. Cordani, President and Chief Executive
Officer. “Our combination with Express Scripts is fueling additional
innovative programs for the benefit of our customers and patients, as we
accelerate our efforts to improve the affordability of health care.”

Total revenues for first quarter 2019 were $37.9 billion. Adjusted
revenues1 were $33.4 billion and reflect strong contributions
from each of Cigna’s ongoing businesses.

Shareholders’ net income for first quarter 2019 was $1.37 billion, or
$3.56 per share, compared with $0.9 billion, or $3.72 per share, for
first quarter 2018.

Cigna’s adjusted income from operations2 for first quarter
2019 was $1.5 billion, or $3.90 per share, compared with $1.0 billion,
or $4.11 per share, for 2018. This reflects strong earnings
contributions led by the Health Services and Integrated Medical segments.

Reconciliations of total revenues to adjusted revenues1 and
of shareholders’ net income to adjusted income from operations2
are provided on the following page, and on Exhibit 1 of this earnings
release.

CONSOLIDATED HIGHLIGHTS

The following table includes highlights of results and reconciliations
of total revenues to adjusted revenues1 and shareholders’ net
income to adjusted income from operations2:

 
Consolidated Financial Results (dollars in millions):
     
Three Months Ended
March 31, December 31,
2019   2018   2018
 
Total Revenues $ 37,946 $ 11,413 $ 14,300
Net Realized Investment Losses (Gains) from Equity Method Investments1 (28) 2 20
Special Items and Transitioning Client Contributions1   (4,489)         (569)
Adjusted Revenues1 $ 33,429 $ 11,415 $ 13,751
 
Consolidated Earnings, net of taxes
Shareholders’ Net Income $ 1,368 $ 915 $ 144
Net Realized Investment Losses (Gains)2 (38) 25 58
Amortization of Other Acquired Intangible Assets2 564 20 103
Special Items and Transitioning Client Contributions1,2   (396)     50     342
Adjusted Income from Operations2 $ 1,498   $ 1,010   $ 647
 
Shareholders’ Net Income, per share $ 3.56   $ 3.72   $ 0.55
Adjusted Income from Operations2, per share $ 3.90   $ 4.11   $ 2.46
 
  • Year to date through May 1, 2019, the Company repurchased 3.1 million
    shares of common stock for approximately $556 million.
  • The debt to capitalization ratio improved to 48.8% at March 31, 2019
    from 50.9% at December 31, 2018.
  • The SG&A expense ratio5 was 9.3% for first quarter
    2019, a significant decrease from 23.5% for first quarter 2018 driven
    by business mix changes resulting from the Express Scripts
    combination, and the health insurance tax suspension.

CUSTOMER RELATIONSHIPS

The following table summarizes our medical customers and overall
customer relationships:

 

Customer Relationships (in thousands):

 

 

As of the Periods Ended
March 31,     December 31,
2019     2018     2018
Commercial 14,016     13,825 13,982
Government 1,405 1,389 1,407
International Markets 1,572     1,555     1,572
Total Medical Customers6 16,993 16,769 16,961
 
Pharmacy6 74,935 8,796 73,230
Behavioral Care6 28,046 26,998 27,215
Dental 17,122 16,521 16,544
Medicare Part D 3,302 784 3,295
International Markets Supplemental Policies6,7 12,576 12,061 12,569
Group Disability and Life Covered Lives6 15,200     15,300     14,800
Total Customer Relationships 168,174     97,229     164,614
 
  • The total medical customer base6 at first quarter 2019 was
    17 million, an organic increase of 32,000 customers year to date and
    224,000 over first quarter 2018 driven by growth in the Select and
    Middle Market segments, partially offset by a decline in National
    Accounts.
  • The pharmacy customer base6 at first quarter 2019 was 75
    million, an organic increase of 1.7 million customers year to date,
    driven by strong new commercial sales.
  • Pharmacy6 and Medicare Part D customers in the first
    quarter 2019 and fourth quarter 2018 include customers gained through
    the completion of the Express Scripts combination on December 20, 2018.

HIGHLIGHTS OF SEGMENT RESULTS

See Exhibit 1 for a reconciliation of adjusted income (loss) from
operations2 to shareholders’ net income.

Health Services

This segment includes a broad range of pharmacy services, including
benefits management, specialty pharmacy services, clinical solutions,
home delivery, and health management services.

   
Financial Results (dollars in millions):
Three Months Ended
March 31, December 31,
2019   2018     2018
 
Adjusted Revenues1 $ 22,460 $ 1,071 $ 3,313
Adjusted Income from Operations, Pre-Tax2 $ 994 $ 83 $ 153
Adjusted Margin, Pre-Tax8 4.4% 7.7% 4.6%
 
  • Cigna completed the combination with Express Scripts on December 20,
    2018. Accordingly, contributions from the Express Scripts business are
    reflected in the Health Services segment results for the entire first
    quarter 2019, a portion of fourth quarter 2018, and are not reflected
    in first quarter 2018 results.
  • Growth in first quarter 2019 adjusted revenues1 and
    adjusted income from operations, pre-tax2 were driven by
    the combination with Express Scripts.
  • Health Services fulfilled 292 million adjusted pharmacy scripts9
    in first quarter 2019, consistent with the company’s expectations.
  • Health Services delivered solid results in first quarter 2019, driven
    by organic growth in pharmacy customers since the start of the year,
    and strong adjusted pharmacy script volumes and performance in
    specialty pharmacy care.

Integrated Medical

This segment includes Cigna’s U.S. Commercial and Government businesses
that provide comprehensive medical solutions to clients and customers.
U.S. Commercial products and services include medical, pharmacy,
behavioral health, dental, vision, health advocacy programs and other
products and services to insured and self-insured customers. Government
solutions include Medicare Advantage, Medicare Supplement, and Medicare
Part D plans for seniors, Medicaid plans, and individual health
insurance coverage both on and off the public exchanges.

   
Financial Results (dollars in millions):
Three Months Ended
March 31, December 31,
2019   2018   2018
 
Adjusted Revenues1 $ 9,195 $ 8,150 $ 8,297
Adjusted Income from Operations, Pre-Tax2 $ 1,170 $ 1,012 $ 643
Adjusted Margin, Pre-Tax8 12.7% 12.4% 7.7%
 
  • Integrated Medical delivered strong results in first quarter 2019, led
    by organic growth and strong margins in our Commercial and Government
    businesses.
  • First quarter 2019 adjusted revenues1 increased 13%
    relative to first quarter 2018, driven by Commercial customer growth
    and expansion of specialty relationships, as well as premium increases
    consistent with underlying cost trends.
  • First quarter 2019 adjusted income from operations, pre-tax2
    and adjusted margin, pre-tax8 reflect strong medical and
    specialty contributions and continued effective medical cost
    performance.
  • Adjusted income from operations, pre-tax2 for first quarter
    2019 and first quarter 2018 included favorable net prior year reserve
    development on a pre-tax basis of $50 million and $51 million,
    respectively.
  • The medical care ratio5 (“MCR”) of 78.9% for first quarter
    2019 reflects strong performance and execution in our commercial and
    government businesses and favorable prior year development, partially
    offset by the addition of the Express Scripts Medicare Part D business
    and the pricing effect of the health insurance tax suspension.
  • Integrated Medical net medical costs payable10 was
    approximately $2.72 billion at March 31, 2019, $2.41 billion at March
    31, 2018 and $2.43 billion at December 31, 2018.

International Markets

This segment includes supplemental health, life and accident insurance
products and health care coverage in our international markets, as well
as health care benefits for globally mobile employees of multinational
organizations.

 

Financial Results (dollars in millions, policies and customers
in thousands):

 
Three Months Ended
March 31,   December 31,
2019   2018   2018
 
Adjusted Revenues1,7 $ 1,394 $ 1,341 $ 1,355
Adjusted Income from Operations, Pre-Tax2 $ 206 $ 217 $ 120
Adjusted Margin, Pre-Tax8 14.8% 16.2% 8.9%
 
As of the Periods Ended
March 31, December 31,
2019   2018   2018
 
International Markets Supplemental Policies6,7 12,576 12,061 12,569
International Markets Medical Customers6 1,572 1,555 1,572
 
  • First quarter 2019 adjusted revenues1,7 grew 4% over first
    quarter 2018, reflecting continued business growth, partially offset
    by some impact from unfavorable foreign currency movements.
  • First quarter 2019 adjusted income from operations, pre-tax2
    and adjusted margin, pre-tax8 reflect business growth,
    offset by unfavorable foreign currency impacts and spending to
    strengthen our capabilities to further long-term growth.

Group Disability and Other Operations

This segment includes Cigna’s Group Disability and Life business which
offers group long-term and short-term disability, and group life,
accident, voluntary and specialty insurance products and services.
Additionally, this segment includes Corporate Owned Life Insurance
(“COLI”) and the Company’s run-off operations.

 

Financial Results (dollars in millions):

 
Three Months Ended
March 31,   December 31,
2019   2018   2018
 
Adjusted Revenues1 $ 1,296 $ 1,271 $ 1,246
Adjusted Income from Operations, Pre-Tax2 $ 84 $ 116 $ 109
Adjusted Margin, Pre-Tax8 6.5% 9.1% 8.7%
 
  • First quarter 2019 adjusted income from operations, pre-tax2
    and adjusted margin, pre-tax8 reflect unfavorable
    disability claims partially offset by strong life results.

Corporate

Corporate reflects interest expense, as well as amounts not allocated to
operating segments and includes intersegment eliminations.

     

Financial Results (dollars in millions):

 
Three Months Ended
March 31, December 31,
2019   2018   2018
 
Adjusted (Loss) from Operations, Pre-Tax2 $ (490) $ (92) $ (148)
 
  • The first quarter 2019 adjusted loss from operations, pre-tax2
    increased as a result of higher interest expense associated with the
    financing of the combination with Express Scripts.

2019 OUTLOOK

Cigna’s outlook for full year 2019 consolidated adjusted income from
operations2,3,4 is in the range of $6.24 billion to $6.4
billion, or $16.25 to $16.65 per share. Cigna’s outlook excludes the
impact of additional prior year reserve development of medical costs and
potential effects of any future share repurchase4.

   

(dollars in millions, except where noted and per share amounts)

Projection for Full-
Year Ending

Change

from Prior

December 31, 2019   Projection
 

2019 Consolidated Operating Metrics

Adjusted Income from Operations2,3,4 $ 6,240 to 6,400 $ + 0 to 40
Adjusted Income from Operations, per share2,3,4 $ 16.25 to 16.65 $ + 0.15 to + 0.25

Adjusted Revenues1,3

$ 132,500 to 134,500 $ + 1,000

SG&A Expense Ratio5

10.0% to 10.5%
Adjusted Tax Rate11 23.5% to 24.5%

2019 Segment-Level Operating Metrics

Adjusted Income from Operations, Pre-Tax2,3,4
Health Services $ 5,050 to 5,200
Integrated Medical $ 3,700 to 3,800 $ + 0 to 50
Adjusted Pharmacy Scripts – Health Services9 1.17 to 1.19 billion
Medical Customer Growth6 300,000 to 400,000 customers
Medical Care Ratio5 80.5% to 81.5%
Medical Cost Trend12 3.5% to 4.5%
 

2020 OUTLOOK

Health Services’ projected 2020 retention rate for the 2019 selling
season for pharmacy services is in the range of 96% to 98%.

The foregoing statements represent the Company’s current estimates of
Cigna’s 2019 consolidated and segment adjusted income from operations2,3,4
and other key metrics as of the date of this release. Actual results may
differ materially depending on a number of factors. Investors are urged
to read the Cautionary Note Regarding Forward-Looking Statements
included in this release. Management does not assume any obligation to
update these estimates.

This quarterly earnings release and the Quarterly Financial Supplement
are available on Cigna’s website in the Investor Relations section (http://www.cigna.com/aboutcigna/investors).
Management will be hosting a conference call to review first quarter
2019 results and discuss full year 2019 outlook beginning today at 8:30
a.m. ET. A link to the conference call is available in the Investor
Relations section of Cigna’s website located at https://www.cigna.com/aboutcigna/investors/events/index.page.

The call-in numbers for the conference call are as follows:

        Live Call
(888) 324-7575 (Domestic)
(210) 234-0013 (International)
Passcode: 5022019
 
Replay
(800) 839-5571 (Domestic)
(402) 220-2073 (International)

It is strongly suggested you dial in to the conference call by 8:15 a.m.
ET.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company
dedicated to improving the health, well-being and peace of mind of those
we serve. Cigna delivers choice, predictability, affordability and
access to quality care through integrated capabilities and connected,
personalized solutions that advance whole person health. All products
and services are provided exclusively by or through operating
subsidiaries of Cigna Corporation, including Cigna Health and Life
Insurance Company, Cigna Life Insurance Company of New York, Connecticut
General Life Insurance Company, Express Scripts companies or their
affiliates, and Life Insurance Company of North America. Such products
and services include an integrated suite of health services, such as
medical, dental, behavioral health, pharmacy, vision, supplemental
benefits, and other related products including group life, accident and
disability insurance.

Cigna maintains sales capability in over 30 countries and jurisdictions,
and has more than 160 million customer relationships throughout the
world. To learn more about Cigna®, including links to follow
us on Facebook or Twitter, visit www.cigna.com.

   
Notes:
 

1.

At the consolidated level, the measure “adjusted revenues” is
not determined in accordance with GAAP and should not be viewed as
a substitute for the most directly comparable GAAP measure, “total
revenues.” We define adjusted revenues as total revenues excluding
revenue contributions from transitioning pharmacy benefit
management clients, Anthem Inc. and Coventry Health Care, Inc.
(the “transitioning clients”), net realized investment results
from equity method investments, and special items. We exclude
these items from this measure because they are not indicative of
past or future underlying performance of the business. See Exhibit
1 for a reconciliation of consolidated adjusted revenues to total
revenues.

 

2.

Adjusted income (loss) from operations is defined as
shareholders’ net income (loss) excluding the following
adjustments: earnings contributions from transitioning clients,
net realized investment results, amortization of acquired
intangible assets, and special items. Special items are identified
in Exhibit 1 of this earnings release. Adjusted income (loss) from
operations is measured on an after-tax basis for consolidated
results and on a pre-tax basis for segment results.

 
Adjusted income (loss) from operations is a measure of
profitability used by Cigna’s management because it presents the
underlying results of operations of Cigna’s businesses and permits
analysis of trends in underlying revenue, expenses and shareholders’
net income. This consolidated measure is not determined in
accordance with accounting principles generally accepted in the
United States (GAAP) and should not be viewed as a substitute for
the most directly comparable GAAP measure, shareholders’ net income.
See Exhibit 1 for a reconciliation of adjusted income from
operations to shareholders’ net income.
 
Effective in the fourth quarter of 2018, Cigna updated its
segments. Refer to our Current Report on Form 8-K filed with the
Securities and Exchange Commission on January 23, 2019 and our
Annual Report on Form 10-K for the year ended December 31, 2018 for
additional information and prior period results on the historic and
new segment bases.
 

3.

Management is not able to provide a reconciliation of adjusted
income from operations to shareholders’ net income (loss) or
adjusted revenues to total revenues on a forward-looking basis
because we are unable to predict, without unreasonable effort,
certain components thereof including (i) future net realized
investment results (from equity method investments with respect to
adjusted revenues) and (ii) future special items. These items are
inherently uncertain and depend on various factors, many of which
are beyond our control. As such, any associated estimate and its
impact on shareholders’ net income could vary materially.

 

4.

The Company’s outlook excludes the potential effects of any
share repurchases or business combinations that may occur after
the date of this earnings release.

 

5.

Operating ratios are defined as follows:

Medical care ratio represents medical costs as a percentage of
premiums for all U.S. commercial risk products, including medical,
pharmacy, dental, stop loss and behavioral products provided
through guaranteed cost or experience-rated funding arrangements,
as well as Medicare Advantage, Medicare Part D, Medicare
Supplement, Medicaid, and individual on and off-exchange products,
within our Integrated Medical segment.

SG&A expense ratio represents enterprise selling, general and
administrative expenses excluding special items and expenses from
transitioning clients, as a percentage of adjusted revenue at a
consolidated level.

 

6.

Customer relationships are defined as follows:

Total medical customers includes individuals in our Integrated
Medical and International Markets segments who meet any one of the
following criteria: are covered under a medical insurance policy,
managed care arrangement, or service agreement issued by Cigna;
have access to Cigna’s provider network for covered services under
their medical plan; or have medical claims and services that are
administered by Cigna.

Pharmacy customer relationships excludes transitioning clients.

International Markets policies exclude International Markets
medical customers included in total medical customers.

Group Disability and Life covered lives are estimated.

 

7.

Cigna owns a 50% noncontrolling interest in its China joint
venture. Cigna’s 50% share of the joint venture’s earnings is
reported in Fees and Other Revenues using the equity method of
accounting under GAAP. As such, the adjusted revenues and policy
counts for the International Markets segment do not include the
China joint venture.

 

8.

Adjusted margin, pre-tax, is calculated by dividing adjusted
income (loss) from operations, pre-tax by adjusted revenues for
each segment.

 

9.

For Health Services adjusted pharmacy scripts, non-specialty
network scripts filled through 90-day programs and home delivery
scripts are multiplied by three. All other network and specialty
scripts are counted as one script. Adjusted pharmacy scripts
guidance does not include script volumes associated with
transitioning clients, nor volumes expected to be insourced from
OptumRx under the terms of the transition services agreement.

 

10.

Medical costs payable within the Integrated Medical segment are
presented net of reinsurance and other recoverables. The gross
medical costs payable balance was $2.96 billion as of March 31,
2019, $2.70 billion as of December 31, 2018, and $2.64 billion as
of March 31, 2018. The Integrated Medical days claims payable was
40.9 days at March 31, 2019, 40.7 days at December 31, 2018 and
41.9 days at March 31, 2018.

 

11.

The measure “adjusted tax rate” is not determined in accordance
with GAAP and should not be viewed as a substitute for the most
directly comparable GAAP measure, “consolidated effective tax
rate.” We define adjusted tax rate as the consolidated income tax
rate applicable to the Company’s pre-tax income excluding net
realized investment results, amortization of acquired intangible
assets, special items, and transitioning clients. Management is
not able to provide a reconciliation to the consolidated effective
tax rate on a forward-looking basis because we are unable to
predict, without unreasonable effort, certain components thereof
including (i) future net realized investment results and (ii)
future special items.

 

12.

Medical cost trend includes all U.S. commercial employer
funding arrangements.

 

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

This press release, and oral statements made with respect to information
contained in this release, may contain forward-looking statements within
the meaning of the Private Securities Litigation Reform Act of 1995.
Forward-looking statements are based on Cigna’s current expectations and
projections about future trends, events and uncertainties. These
statements are not historical facts. Forward-looking statements may
include, among others, statements concerning our projected adjusted
income (loss) from operations outlook for 2019, on both a consolidated
and segment basis; projected adjusted revenue outlook for 2019;
projected global medical customer growth over year end 2018; projected
growth beyond 2019; statements concerning our long-term projected
adjusted income (loss) from operations outlook; projected medical care
and SG&A expense ratios and medical cost trends; projected adjusted
pharmacy scripts; our projected consolidated adjusted tax rate; future
financial or operating performance, including our ability to deliver
affordable, personalized and innovative solutions for our customers and
clients; future growth, business strategy, strategic or operational
initiatives; economic, regulatory or competitive environments,
particularly with respect to the pace and extent of change in these
areas; financing or capital deployment plans and amounts available for
future deployment; our prospects for growth in the coming years; the
merger (the “Merger”) with Express Scripts Holding Company (“Express
Scripts”) and other statements regarding Cigna’s future beliefs,
expectations, plans, intentions, financial condition or performance. You
may identify forward-looking statements by the use of words such as
“believe,” “expect,” “plan,” “intend,” “anticipate,” “estimate,”
“predict,” “potential,” “may,” “should,” “will” or other words or
expressions of similar meaning, although not all forward-looking
statements contain such terms.

Forward-looking statements are subject to risks and uncertainties, both
known and unknown, that could cause actual results to differ materially
from those expressed or implied in forward-looking statements. Such
risks and uncertainties include, but are not limited to: our ability to
achieve our financial, strategic and operational plans or initiatives;
our ability to predict and manage medical and pharmacy costs and price

Contacts

INVESTOR RELATIONS CONTACT:
Will McDowell
215-761-4198
[email protected]

MEDIA CONTACT:
Ellie Polack
860-902-4906
[email protected]

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