CIGNA CORPORATIONINVESTOR PRESENTATION
May 3, 2018
Forward-looking statements and non-GAAP measures
CAUTIONARY STATEMENT FOR PURPOSES OF THE “SAFE HARBOR” PROVISIONS OF THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995
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 2018, on both a consolidated and segment basis; projected total revenue growth and global medical customer growth, each over year end 2017; projected growth beyond 2018; projected medical care and operating expense ratios and medical cost trends; our projected consolidated adjusted tax rate; future financial or operating performance, including our ability to deliver 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 proposed 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 costs and price effectively and develop and maintain good relationships with physicians, hospitals and other health care providers; the impact of modifications to our operations and processes; our ability to identify potential strategic acquisitions or transactions and realize the expected benefits of such transactions, including with respect to the Merger; the substantial level of government regulation over our business and the potential effects of new laws or regulations or changes in existing laws or regulations; the outcome of litigation, regulatory audits, investigations, actions and/or guaranty fund assessments; uncertainties surrounding participation in government-sponsored programs such as Medicare; the effectiveness and security of our information technology and other business systems; unfavorable industry, economic or political conditions, including foreign currency movements; acts of war, terrorism, natural disasters or pandemics; our ability to obtain shareholder or regulatory approvals required for the Merger or the requirement to accept conditions that could reduce the anticipated benefits of the Merger as a condition to obtaining regulatory approvals; a longer time than anticipated to consummate the proposed Merger; problems regarding the successful integration of the businesses of Express Scripts and Cigna; unexpected costs regarding the proposed Merger; diversion of management’s attention from ongoing business operations and opportunities during the pendency of the Merger; potential litigation associated with the proposed Merger; the ability to retain key personnel; the availability of financing, including relating to the proposed Merger; effects on the businesses as a result of uncertainty surrounding the proposed Merger; as well as more specific risks and uncertainties discussed in our most recent report on Form 10-K and subsequent reports on Forms 10-Q and 8-K available on the Investor Relations section of www.cigna.com as well as on Express Scripts’ most recent report on Form 10-K and subsequent reports on Forms 10-Q and 8-K available on the Investor Relations section of www.express-scripts.com. You should not place undue reliance on forward-looking statements, which speak only as of the date they are made, are not guarantees of future performance or results, and are subject to risks, uncertainties and assumptions that are difficult to predict or quantify. Cigna undertakes no obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise, except as may be required by law.
NON-GAAP MEASURES AND FINANCIAL INFORMATION
The Company uses adjusted income from operations as the principal measure of performance when describing its financial results and outlook. On a consolidated basis, adjusted income from operations isnot determined in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Adjusted income from operations is defined as shareholders’ net income (loss)excluding after-tax realized investment results, net amortization of other acquired intangible assets, special items and, for periods ended on or prior to December 31, 2014, the results of Cigna’sGuaranteed Minimum Income Benefits (GMIB) business. Management uses adjusted income from operations to measure financial performance because it presents underlying results of operations andpermits analysis of trends in underlying revenue, expenses and shareholders’ net income. On a consolidated basis, adjusted income from operations should not be viewed as a substitute for the mostdirectly comparable GAAP measure - shareholders’ net income.
*In this presentation, the term “earnings” means adjusted income from operations and “earnings per share” means adjusted income from operations on a fullydiluted per share basis. The appendix to this presentation contains a reconciliation of adjusted income from operations on a consolidated basis to shareholders’ netincome, the most directly comparable GAAP measure. Management is unable to provide a forward-looking reconciliation of adjusted income from operations toshareholders’ net income for full year 2018 because future net realized investment results, net amortization of other acquired intangible assets and special itemscannot be identified or reasonably estimated at this time. Peer information is presented on the basis of their respective principal financial performance measure.
© 2018 Cigna 2
Important information for investors
© 2018 Cigna 3
IMPORTANT INFORMATION ABOUT THE TRANSACTION AND WHERE TO FIND IT
This communication does not constitute an offer to buy or solicitation of an offer to sell any securities. In connection with the proposed transaction, the newly formed company which will become the holding company following the transaction (“Holdco”) intends to file with the SEC a registration statement on Form S-4 that will include a joint proxy statement of Cigna and Express Scripts that also constitutes a prospectus of Holdco. Cigna and Express Scripts also plan to file other relevant documents with the SEC regarding the proposed transaction. INVESTORS AND SECURITY HOLDERS ARE URGED TO READ THE JOINT PROXY STATEMENT/PROSPECTUS AND OTHER RELEVANT DOCUMENTS FILED WITH THE SEC CAREFULLY AND IN THEIR ENTIRETY IF AND WHEN THEY BECOME AVAILABLE BECAUSE THEY WILL CONTAIN IMPORTANT INFORMATION. You may obtain a free copy of the joint proxy statement/prospectus (if and when it becomes available) and other relevant documents filed by Holdco, Cigna and Express Scripts with the SEC at the SEC’s website at www.sec.gov. Copies of documents filed with the SEC by Cigna will be available free of charge on Cigna’s website at www.Cigna.com or by contacting Cigna’s Investor Relations Department at (215) 761-4198. Copies of documents filed with the SEC by Express Scripts will be available free of charge on Express Scripts’ website at www.express-scripts.com or by contacting Express Scripts’ Investor Relations Department at (314) 810-3115.
PARTICIPANTS IN THE SOLICITATION
Cigna (and, in some instances, Holdco) and Express Scripts and their respective directors and executive officers may be deemed to be participants in the solicitation of proxies in respect of the proposed transaction under the rules of the SEC. Investors may obtain information regarding the names, affiliations and interests of directors and executive officers of Cigna (and, in some instances, Holdco) in Cigna’s Annual Report on Form 10-K for the year ended December 31, 2017, which was filed with the SEC on February 28, 2018, and its definitive proxy statement for its 2018 Annual Meeting, which was filed with the SEC on March 16, 2018. Investors may obtain information regarding the names, affiliations and interests of Express Scripts’ directors and executive officers in Express Scripts’ Annual Report on Form 10-K for the year ended December 31, 2017, which was filed with the SEC on February 27, 2018, and its proxy statement for its 2018 Annual Meeting, which was filed with the SEC on March 29, 2018. You may obtain free copies of these documents at the SEC’s website at www.sec.gov, at Cigna’s website at www.Cigna.com or by contacting Cigna’s Investor Relations Department at (215) 761-4198. Copies of documents filed with the SEC by Express Scripts will be available free of charge on Express Scripts’ website at www.express-scripts.com or by contacting Express Scripts’ Investor Relations Department at (314) 810-3115. Other information regarding the participants in the proxy solicitation and a description of their direct and indirect interests, by security holdings or otherwise, will be contained in the joint proxy statement/prospectus and other relevant materials to be filed with the SEC regarding the proposed transaction if and when they become available. Investors should read the joint proxy statement/prospectus carefully and in its entirety when it becomes available before making any voting or investment decisions.
NO OFFER OR SOLICITATION
This communication is for informational purposes only and not intended to and does not constitute an offer to subscribe for, buy or sell, the solicitation of an offer to subscribe for, buy or sell or an invitation to subscribe for, buy or sell any securities or the solicitation of any vote or approval in any jurisdiction pursuant to or in connection with the proposed transaction or otherwise, nor shall there be any sale, issuance or transfer of securities in any jurisdiction in contravention of applicable law. No offer of securities shall be made except by means of a prospectus meeting the requirements of Section 10 of the Securities Act of 1933, as amended, and otherwise in accordance with applicable law.
• Identity and mission
• Strong track record
• Growth platforms
• Financial priorities and expectations
• Cigna and Express Scripts combination
• Investor considerations
Table of contents
© 2018 Cigna 4
Identity and mission
5© 2018 Cigna
To improve the health, well-being and sense of security of the people we serve
Our Mission
To be champions for our customers and our communities
Our Role
We are a Global Health Service Company
Who We Are
CanadaItaly
USAPortugal
Ireland
BelgiumDenmark, Norway, Sweden
Netherlands
Germany
Spain
Thailand
Singapore
New Zealand
Indonesia
South KoreaChina
TaiwanHong Kong
France
Switzerland
U.K.
UAE
Australia
Saudi Arabia
Oman
KuwaitBahrain
Turkey
India
Global footprint
Well established in attractive geographies
Over 95 million customer relationships
Operating in 30+ countries/jurisdictions
More than 45,000 employees
6© 2018 Cigna
Global medical network across 190+ countries
Lebanon
7© 2018 Cigna
Strong track record in a challenging market
$18.3 $21.1 $21.9
$29.1 $32.4
$34.9 $37.9
$39.7 $41.6
2009 2010 2011 2012 2013 2014 2015 2016 2017
Achieving strong performance
8© 2018 Cigna*A reconciliation of earnings per share to shareholders’ net income per share, the most directly comparable GAAP measure, can be found in the Appendix.
8-Year Revenue CAGR
Delivered cumulative Total Shareholder Return of 479% from YE 2009 – YE 2017
Total Revenue Earnings Per Share
8-Year EPS* CAGR 13%11%
($ in billions)
Double-digit top-line and bottom-line growth over an 8-year period
$4.07 $4.53 $5.11
$6.49 $7.29
$7.87 $8.66
$8.10
$10.46
2009 2010 2011 2012 2013 2014 2015 2016 2017
Anthem
4.0%
Humana CignaAetna
4.7%
3.0%
United
4.7%
6.1%
Strong margins and ROIC drive financial flexibility
9
2009–2017After-tax margins
After-tax margins and returns on invested capital are annual averages for 2009–2017.
Aetna
11%
Anthem CignaHumana
12%
7%
United
12%
14%
2009–2017Returns on invested capital
© 2018 Cigna
Strong record of total shareholder return
10
2009–2017 Average annual TSR*
Cigna delivered cumulative TSR of 479% from YE 2009–YE 2017
Managed Care** S&P 500Cigna
16%
26%
36%
Peer Group***
21%
*Annual average TSRs are presented for full years 2009 through 2017.**Managed Care includes: Aetna, Anthem, Humana and UnitedHealth.***Broader peer group includes: Aetna, Aflac, Anthem, The Hartford, HealthNet (through 2015), Humana, Manulife, MetLife, Unum and UnitedHealth.© 2018 Cigna
11© 2018 Cigna
Evolved strategy expands avenues for growth and performance through enhanced customer value
12© 2018 Cigna
Global market forces …
… drive key needs for the people we serve
Greater affordability and productivity
Value-based partnering and care delivery
Personalized, affordable solutions
Access and affordability solutions
Health Care ProfessionalsClients GovernmentCustomers
Improved health, vitality and productivity
Communities
Tremendous need for personalization, affordability and predictability
Affordability and accessibility challenges
Regulatory and legislative climate
Aging population Eroding health status
Changing role of consumers
Technologicalinnovation
Cigna’s enterprise strategy
13© 2018 Cigna
Go Deeper Go Local Go BeyondTo expand and deepen our
customer, client and partner relationships; depth in targeted
sub-segments, geographies
To ensure our solution suite and services meet customer, client and partner needs at a
local market level
To innovate and further differentiate our businesses, the experiences we deliver, and overall social impact
How we will win – Focus on differentiated strengths
Affordability
Personalization
CustomerValue
Be the Undisputed Partner of Choice
Accelerating Next Generation Integration
Make the Complex Simpler
© 2018 Cigna 14
STRATEGIC IMPERATIVES ENABLERS OBJECTIVE
To win in the marketplace, we focus on our differentiated strengths to create unique and sustainable value for our customers driven by achieving the right balance of Affordability and Personalization delivered through three key strategic imperatives
15© 2018 Cigna
Continuing to deliver differentiated value and growth from our four growth platforms
Targeted growth platforms
16© 2018 Cigna
SENIORSCOMMERCIAL EMPLOYER
GLOBAL SUPPLEMENTAL
BENEFITS
GROUP DISABILITY AND LIFE
High single-digit average annual enterprise revenue growth target over the long term
Business overview / How we win
Global Health Care – Commercial employer
17
• Leverage information, incentives and care resources to help health care providers better align around value-based care models, to deliver a differentiated, more coordinated approach to care
• Deeply integrated medical and specialty offerings allow us to leverage the combined data and insights across our solutions to improve outcomes for the benefit of customers and clients
• Innovative solutions to meet market needs and actively improve the customer experience through new technology and digital enablement solutions
• Unique capabilities in the underserved 51–500 lives segment, including integrated administrative services only (ASO) with Stop Loss solutions, onsite medical management programs and transparent reporting of cost drivers
Product portfolio/Customer profile
• ASO• Experience Rated• Guaranteed Cost
• Medical• Stop Loss• Dental
• ~13.8M customers• Over 2.3M customers in
collaborative arrangements• ~85% of customers in ASO
arrangements
Products & Services Funding Solutions Medical Customers*• Pharmacy• Behavioral• Health Advocacy
& Coaching
© 2018 Cigna
* As of 3/31/18
Delivered avg. annual after-tax margins:
High single digits
8%RevenueCAGR
20172009
© 2018 Cigna
Growth & margins
Commercial employer – Medical cost trend
18© 2018 Cigna
Trends represent total book of business, all funding arrangements. Reported results for Cigna consistent with external disclosure; for 2013, 2016, and 2017, final disclosure was less than 5%, less than 4%, and less than 3%, respectively.
Superior results driven by key differentiators:• Consumer engagement and alignment of incentives• Integrated medical and specialty solutions• Advanced Cigna collaborative care arrangements with providers
Leading U.S. total medical cost trend results
ANTM UNH CI
7%
5.5%–6.5%
2018 Medical Cost Trend Guidance
4%–5%
5.5%–6.5%
3%
4%
5%
6%
2%
4%
6%
8%
2010 2011 2012 2013 2014 2015 2016 2017
2010-2017 Reported Medical Cost Trend
CI
AET
ANTM
UNH
2010-2017 Reported Medical Cost Trend
2,000
2,500
3,000
3,500
4,000
4,500
5,000
5,500
6,000
2009 2010 2011 2012 2013 2014 2015 2016 2017
500 600 700 800 900
1,000 1,100 1,200 1,300 1,400 1,500 1,600
2009 2010 2011 2012 2013 2014 2015 2016 2017 4,000
5,000
6,000
7,000
8,000
9,000
10,000
11,000
12,000
2009 2010 2011 2012 2013 2014 2015 2016 2017
Only company in our peer group to deliver total medical customer* growth for 8 consecutive years
Commercial employer – Medical customer growth
19
Middle Market Segment***:4% average annual growth
Number of customers** (000) Number of customers** (000)
Number of customers** (000)
© 2018 Cigna
Select Segment***:13% average annual growth
National Accounts:Maintaining share in a stable market
*Medical customers include individuals 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.
**As of 12/31/17.
***Presentation above treats Select Segment as Employer groups with 51-250 employees and Middle Market as employer groups with 251-500 employees.
Commercial employer – Consultative approach
20© 2018 Cigna
Solution Based Seek Alignment Simplifying the Complex
Funding agnostic to satisfy differentiated market needs
Designing customized benefit programs and offering a variety of funding mechanisms to meet each client’s specific needs
Some examples:
Behavioral• Reduces medical costs by
helping people quit smoking and manage weight and stress
Pharmacy• Medical cost savings through
additional customer touchpoints, driving more health engagement in specialty condition management, case management and health coaching
Dental• Appropriate treatment of gum
disease drives lower medical costs for those with diabetes, heart disease and stroke
Creating personalized value for customers by harnessing insights to improve outcomes
Commercial employer – Integration of specialty solutions
21© 2018 Cigna
Low-Mid High
Penetration Rates – Book of Business
Low
• Vision• EAP• Disability• Oncology
50–70%Less than 30% 30–50% Over 70%
Mid-High
• Stop Loss• Prenatal
Program
• Behavioral• Utilization
& Case Management
• Pharmacy• Dental• Chronic
ConditionManagement
Penetration rates as a percentage of total medical customer base; does not include non-medical customers.
Commercial Employer – Cigna Collaborative Care1
22© 2018 Cigna
1. Cigna internal analysis of existing arrangements as of April 2018. Subject to change. Map is illustrative.2. Cigna July 2017 analysis (weighted average) of top seven Accountable Care program groups nationally, per metric compared to local market
in 2016. Comparisons to market are established using Cigna internal claims data.3. Cigna June 2017 analysis of 2016 data of Accountable Care program groups nationally, active at least one year, that achieved savings.
Average saved compared to market PMPM trend for 2015 and 2016.4. Cigna August 2017 analysis of national medical book of business customers in the top 40 US markets, defined by market size, within 15-mile
zip code radius (zip code to zip code distance) of one Accountable Care program physician. Subject to change.
212 Accountable Care programs167 Specialist programs140 Hospital programs7 Delivery system joint ventures
Developing value-based care programs for our Commercial customers for a decade, and almost two decades for Medicare Advantage customers
• Top performing participating Accountable Care program providers demonstrated a quality performance of 10% or better than market2 and saved 3.2% in total medical cost.3
• 99% of our customers in the U.S. are within 15 miles of a provider in a Accountable Care program arrangement.4
IA
Commercial employer – Personalized solutions
23
Making the complex simpler to improve the customer experience
Personal care delivered by local value-based providers
Bringing our approach to personalization to life through innovative new solutions
© 2018 Cigna
Global Health Care – Seniors
24
• Medicare Advantage (MA)– Unique model focused on engagement and risk-sharing
arrangements with physicians– Strong clinical capabilities and extensive experience in
care coordination– Top 3 market presence in our established MA markets– Ongoing member satisfaction and high-quality
programs• MA Part D – strong networks and formularies with focus on
improving total pharmacy costs
* 25% revenue CAGR includes inorganic growth from the HealthSpring acquisition in January 2012.** As of 3/31/18.
© 2018 Cigna
Product portfolio/Customer profile
• Presence in 16 states• Expect to expand into 1–2 new
markets per year
• 433,000 customers**• 60% of customers in 4 star or
greater plans in 2018
• 784,000 customers**
Medicare Advantage Footprint MA Part D
25%RevenueCAGR*
20172009
Growth & marginsBusiness overview/How we win
Delivered avg. annual after-tax margins: Low single digits
Seniors – Provider engagement model
25© 2018 Cigna
Year-over-year improvements in clinical
quality measures
Provider engagement model is a differentiator
• Pioneer in value-based care
Over 85% of our customers are cared for
by a provider in a value-based
arrangement
• Partner with providers • Help physicians remain independent
Positioned for strong, sustained customer growth
Seniors – Customer experience
26© 2018 Cigna
Positive customer satisfaction
Year-over-year improvements in clinical quality measures
• 2017 performance resulted in over 80% of all HEDIS* Star measures exceeding prior-year rates or maintaining 5 Star performance
• Strength in customer likelihood to recommend, NPS* as high as 70
*NPS is net promoter score; HEDIS stands for Health Care Effectiveness Data and Information Set.
Delivering a positive customer experience
• Leveraging deep consumer insights to drive product innovation and optimize distribution
• Meeting the rapidly growing demand for health protection needs
• Targeting the growing middle class and seniors’ populations globally
• Leading innovative, direct to consumer distribution capabilities
• Easy to understand, affordable products that are designed to fill in gaps in coverage
• Locally licensed and managed by strong, locally developed talent
Global Supplemental Benefits
27© 2018 Cigna© 2018 Cigna
Product portfolio
• Medicare Supplement• Individual Private Medical• Dental
• Hospitalization• Critical Illness• Personal Accident
• Travel• Term Life• Variable Life
Fixed cash payments Health Other
Business overview/How we win Growth & margins
17%RevenueCAGR
20172009 Delivered avg. annual after-tax margins:
High single digits
18%
32%19%
31%
2017 Sales by Distribution Channel
Global Supplemental Benefits – Distribution channels
28© 2018 Cigna
Diversity of distribution model distinguishes Cigna from competitors
Bancassurance
Telemarketing
Direct to Consumer
IndividualAgent/Broker
Group Disability and Life
29
• Disability absence management model that reduces overall costs to employers
• Integration of disability products with medical and specialty offerings, promoting health and wellness, and optimizing employee productivity
• Complementary portfolio of group disability, life and accident offerings
• Best-in-class return-to-work results that enhance workforce productivity for employers
© 2018 Cigna
4%Revenue
CAGR
20172009
Growth & marginsBusiness overview/How we win
Product portfolio
• Basic-term• Voluntary term• Group universal
• Short-term• Long-term• FMLA
• Personal basic/voluntary• Business travel• Critical Illness/Accidental
Injury
Disability Life Accident
Delivered avg. annual after-tax margins:
High single digits
Group Disability and Life – Disability resolution rates
30© 2018 Cigna
Industry-leading return-to-work rates
• Pioneer in value based care
9.6% 9.9%9.3%
10.1% 10.4%9.5%
2011 2012 2013 2014 2015 2016
Disability resolution rates*Cigna Industry Median
Superior results driven by key differentiators:• Integration with medical benefits enables earlier intervention, quicker decisions and increased resolutions• High investments into pre-disability and absence prediction and prevention programs that decrease the
time a customer is away from work• Significant clinical and vocational interventions soon after the onset of a disability and at recurring
intervals thereafter* Resolution rates above represent percentage of customers on disability who returned to active service within 12 months of their initial date of receiving disability benefits.
31© 2018 Cigna
Financial expectations and priorities
2018 Outlook*
32
*Outlook provided in Cigna’s earnings release on May 3, 2018 and excludes the potential effects of future capital deployment and additional prior year reserve development.**See page 2 for definitions of earnings and earnings per share.
© 2018 Cigna
Ongoing contributions across a diversified portfolio of businesses
© 2018 Cigna
($ in millions, except per share amounts)
Earnings** 2018 Outlook % GrowthGlobal Health Care $2,670 - $2,730Global Supplemental Benefits $390 - $410Group Disability and Life $330 - $350Ongoing Businesses $3,390 - $3,490 20% - 23%
Consolidated $3,170 - $3,270 19% - 23%
Earnings Per Share* $12.85 - $13.25 23% - 27%
Long-term target margins and revenue growth
33© 2018 Cigna
Group Disability & Life Mid single digits
Global SupplementalBenefits Mid teens
Medicare Advantage High single digits
Business
Commercial Employer
-
High single digits
Long-term TargetRevenue Growth
Mid to high single digits
Low to mid single digits
High single digits
Mid to high single digits
Long-term TargetAfter-tax Margins
Capital deployment priorities – Forward view
34© 2018 Cigna
Reinvesting in businessesto support
long-term growth
Strategic M&A to enhance capabilities and scale in targeted
areas of focus
Returning capital to shareholders
Strategic M&A priorities• Global expansion• U.S. Seniors• Pharmacy and physician engagement capabilities• Retail capabilities• Government risk-based programs
35© 2018 Cigna
Cigna and Express Scripts Combination
The combination is part of the solution
36
© 2018 Cigna
Focus on the whole person and
overall improvement of
total health
Expanding our reachImproving affordability
Driving stakeholder value throughalignment, transparency and choice
Strategic Goal: Through the power of alignment we will be the company to grow and nurture patients and physician relationships…
Benefits of the combination
37
Accelerates the Strategies of Both Companies by Driving Deeper Alignment Across Critical Elements of the Healthcare System and Positioning the Combined Company to Deliver Over $50 Billion in Savings1
Medical Insurance
Health and Wellness Services
AlignedHealthcare Providers
Pharmacy Mgmt
Services
Pharma Supply Chain
How?• Unrivaled Predictive Capabilities: We will
harness insights to predict health and treatment adherence risks
• Coordinated Care and Treatment: We will have the reach to coordinate pharmacy, medical and behavioral healthcare and treatment – even for the most complex cases
• Aligned Incentives: We will lead the value-based and outcomes-based reward structure across the healthcare spectrum (e.g. with doctors, pharmacists, drug manufacturers) and will be rewarded based on the value we generate for the benefit of clients and customers
Tools• Data and Technology: We will have combined medical /
pharmacy information for over 100 million customers and flexible technology to share insights from that data in an actionable way
• Deep Relationships: We will deepen relationships with physicians (through our 500+ collaborative accountable care organizations); pharmacists (through our pharmacy networks); and drug manufacturers (through our supply chain management)
• Integrated Model: We will have the ability to share information seamlessly across our various businesses to deliver integrated care and support
Results• Lower Costs: We will be positioned to return
over $50 billion of savings to clients and customers per year
• Better Quality of Care: More gaps in care are closed and customers are able to get the right care and treatment from the right doctor at the right time
• Increased Customer Satisfaction: More personalized care and choice (including [in site of] care and treatment)
• Health Plan Clients: Will benefit from additional agnostic, portfolio of services
. 1. $50 billion represents the annual savings opportunity in 2021 for the combined Cigna-Express Scripts membership population, assuming the combined company achieves medical/pharmacy trend equal to CPI (Consumer Price Index).
• Best‐in‐class medical and pharmacy cost trends• Further expand and deepen our collaborative relationships• Accelerate value based care with pharmacy
Further Improve Affordability
• Expand pharmacy penetration and accelerate MA and PDP growth• Broaden employer, health plan and government agency offerings with customized tailored
solutions including private label• Broaden geographic reach and segment depth to middle market
Poised for Sustained Growth
• Mid‐teens EPS accretion in year 1• Increased 2021 EPS target to $20 ‐ $21 per share• Outstanding free cash flow with approximately $6 billion of free cash flow in 2021
Deliver Differentiated Financial Results
• Enhanced value based care with leading clinical capabilities• Open architecture to adapt to evolving market• Significant free cash flow and balance sheet flexibility
Positioned for Long‐term Success
Addressing the evolving needs of a dynamic healthcare market
38
• Integrated U.S. Medical• Integrated U.S. Services• Global Employer and Individual
Three Growth Platforms
Proprietary and Confidential. Do not duplicate or distribute. Use and distribution limited to authorized personnel.39
Delivers Immediate and Longer‐Term Cost Savings
• Greater than $600 million of retained synergies, primarily administrative
• Billions of savings for customers and clients fuels further growth
Maintains Balance Sheet Flexibility
• Robust free cash flow generation (project approximately $6 billion of free cash flow in 2021)
• Pro forma debt-to-capitalization of ~49%, projected to return to 30s in 18-24 months post-close; committed to retaining investment grade debt ratings
• Additional capital deployment capability beyond debt repayment in 2019 – 2020
• Improves affordability, expands geographic and customer reach and broadens service offerings
• Long-term Revenue CAGR target of 6% – 8%
• Delivers strong, sustainable margin profile
Strengthens Growth Profile
• Mid-teens accretion in first full year post-close, excluding any contribution from Express Scripts’ transitioning clients and excluding revenue synergies
• Increased 2021 EPS target to $20 – $21
Drives Strong EPS Accretion
Delivers differentiated financial results and shareholder value
Strong track record of delivering value
Investor considerations
40© 2018 Cigna
Clear forward strategy
Commitment to innovation
Value-creating combination with Express Scripts
Attractive long-term outlook
Strong path for sustained growth
Succeeding for shareholders
© 2018 Cigna 41
$20 to $21 EPS by 2021
7%–9% 3%–4%10%–13%
EARNINGSCONTRIBUTION
CAPITAL DEPLOYMENT
EARNINGS PER SHARE
Long-term average annual growth targets
plus additional impact of combination with Express Scripts
Appendix
42© 2018 Cigna© 2018 Cigna
Reconciliation of GAAP to Non-GAAP Financial Measures(Dollars in millions, except per share amounts)
12/31/2009 12/31/2010 12/31/2011 12/31/2012 12/31/2013EPS (FULLY DILUTED):
Shareholders' net income 4.69$ 4.65 4.59 5.61 5.18 Results of guaranteed minimum income benefits (0.76) 0.09 0.49 (0.10) (0.09) Net realized investment losses (gains) 0.09 (0.18) (0.15) (0.11) (0.49) Amortization of other acquired intangible assets 0.13 0.13 0.15 0.50 0.51 Special items (0.08) (0.16) 0.03 0.59 2.18
Adjusted income from operations 4.07$ 4.53 5.11 6.49 7.29
12/31/2014 12/31/2015 12/31/2016 12/31/2017EPS (FULLY DILUTED):
Shareholders' net income 7.83$ 8.04 7.19 8.77 Results of guaranteed minimum income benefits - - - - Net realized investment losses (gains) (0.40) (0.15) (0.42) (0.61) Amortization of other acquired intangible assets 0.44 0.30 0.36 0.26 Special items - 0.47 0.97 2.04
Adjusted income from operations 7.87$ 8.66 8.10 10.46
YEAR ENDED
YEAR ENDED
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