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CIHealth insurance & pharmacy services

The Cigna Group

Narrow moatHigh uncertainty

Updated

Price
$302.30
Fair value
fair value $354.00
Discount
14.6% below fair value
LSEG rating
LSEG 2.07 — lower is better (1–5)
Next earnings
Earnings Nov 5 ·

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In short

Thesis
The market fears that pressure on pharmacy benefit managers will cut Cigna's profits, and steady specialty growth with stable pharmacy margins over the next four to six quarters can close the gap.
Gap
Can close. The Q3 2026 report and the 2027 outlook show whether pharmacy benefit profit stabilizes while specialty grows.
Next test
: Q3 2026 earnings: pharmacy benefit profit

About

The Cigna Group has two main businesses. Evernorth Health Services provides pharmacy benefit services and specialty pharmacy and care services. Cigna Healthcare sells medical plans and stop loss coverage, mainly to U.S. employers, and health plans in international markets. At June 30, 2026, Cigna had 18.4 million medical customers and 118.2 million pharmacy customers.

Total revenues were $140.2 billion in the first half of 2026. Cigna sold its Medicare Advantage business to Health Care Service Corporation in March 2025 and plans to exit the Individual and Family Plans medical business on January 1, 2027. Brian Evanko is President and CEO.

Thesis

The market prices Cigna for pressure on the profits of its pharmacy benefit business. Clients and government programs press pharmacy benefit managers to lower drug costs, and Cigna is moving to a rebate-free model that it announced in October 2025. Pre-tax adjusted income from Pharmacy Benefit Services fell 27% in Q2 2026 because of large client contract renewals and other client-focused changes. Pharmacy customers fell 4% in the first half of 2026 as some clients left.

For the gap to close, three things must be true. Specialty and Care Services must keep growing, as in Q2 2026, when its pre-tax adjusted income rose 22%. Pharmacy Benefit Services profit must stabilize after the move to the new model. Cigna must deliver adjusted EPS of at least $30.45 in 2026 and growth of 10% to 14% a year through 2030, the target from its Investor Day on September 30, 2026.

The Q3 2026 report on November 5, 2026 and the 2027 outlook in early 2027 are the next tests. If these checks pass, the gap can close over the next four to six quarters. The main reason it may not close is new laws or rules on pharmacy benefit managers that cut their profits more than Cigna expects.

Checkpoints

  1. Nov 5, 2026Pending
    Q3 2026 earnings: pharmacy benefit profitAdjusted EPS guidance of at least $30.45 kept or raised and a smaller decline in Pharmacy Benefit Services income pass; a guidance cut or a larger decline fail.
  2. Q1 2027 · est.Pending
    2027 outlook2027 adjusted EPS guidance within the 10% to 14% long-term growth target pass; guidance below that range fails.

Every passed and failed checkpoint across all picks

Balance sheet

Cash
$6.3B
Debt
$31.9B
Net debt
$25.6B
Interest cover
7.1×
times profit pays interest
Credit line
$6.5B
undrawn, to April 2030

Cash against debt

Cash$6.3B
Debt$31.9B

debt covered by cashnet debt $25.6B

When the debt is due

12 months$2.8B
Later$29.1B

Cigna funds itself with senior notes and commercial paper. At June 30, 2026, short-term debt was $2.79 billion and long-term debt was $29.09 billion, for total debt of $31.88 billion.

Risks

  • New laws, rules or client demands can change how pharmacy benefit managers earn money. Pre-tax adjusted income from Pharmacy Benefit Services fell 27% in Q2 2026 after large contract renewals. Further changes can cut profits more.
  • The Cigna Healthcare medical care ratio rose to 84.5% in Q2 2026 from 83.2% a year earlier. Higher medical costs than Cigna priced for lower insurance margins.
  • Pharmacy customers fell 4% in the first half of 2026 because of client transitions and lower membership at health plan clients. The loss of more large clients lowers revenue and profit.
  • Total debt was $31.9 billion at June 30, 2026, and much of the cash is held at regulated subsidiaries. Cigna keeps a debt to capitalization ratio of about 43%.

Recent events

  • September 30, 2026Cigna held its Investor Day and introduced its Lead to One vision. It announced $3 billion of multi-year modernization and productivity initiatives, reaffirmed its 2026 guidance of adjusted EPS of at least $30.45, and set a target of 10% to 14% average annual adjusted EPS growth through 2030.
  • July 30, 2026Cigna reported Q2 2026 results. Total revenues rose 7% to $71.7 billion, and adjusted EPS was $7.78, up from $7.20. Pre-tax adjusted income from Specialty and Care Services rose 22%, while Pharmacy Benefit Services fell 27%. The Cigna Healthcare medical care ratio was 84.5%. Cigna raised its 2026 outlook to adjusted EPS of at least $30.45.
  • April 30, 2026Cigna reported Q1 2026 results, with adjusted EPS of $7.79 and total revenues of $68.5 billion. In April 2026, it also announced that it will exit the Individual and Family Plans medical business on January 1, 2027.

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