Connecting for a
Healthier Future2022 ENVIRONMENTAL , SOCIAL , AND GOVERNANCE REPORTTA B L E O F CO N T E N TS

INTRODUCTION

H E A LT H Y S O C I E T Y

H E A LT H Y W O R K F O R C E

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ESG PERFORMANCE METRICS

Table of Contents
Introduction

3

Healthy Society

12
13

ESG Performance Tables
and Reporting Indices

About This Report

4

Sustainable Health Care

68

A Message from Leadership

5

Product Service and Quality

21

Performance Tables

69

About The Cigna Group8

Health Equity

24

Sustainability Accounting Standards Board (SASB)73

Our ESG Vision, Framework, and Strategy

9Community Resilience

29

Global Reporting Index (GRI)76

Task Force on Climate-related Financial
Disclosures (TCFD)

88

United Nations (UN) Global Compact

93

UN Sustainable Development Goals (SDGs)

95

External Assurance Letter

97

Healthy Workforce

34

Employee Health, Safety, and Vitality

35

Diversity, Equity, and Inclusion (DEI)
within Our Workforce

40

Human Capital Development

44

Healthy Environment48

Climate Change and Emissions

49

Sustainable Operations

52

Healthy Company

55

Leadership and Accountability

56

Business Ethics and Compliance

58

Data Protection

61

Responsible Supply Chain

65
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Introduction

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About This Report
The Cigna GroupSM 2022 Environmental, Social, and Governance (ESG) Report,(1) which
reports on our overall ESG performance, covers activities and performance in calendar-year
2022. Performance data includes combined data for The Cigna Group and its subsidiaries,
unless otherwise noted. The report addresses the parent company and wholly owned
subsidiaries comprising U.S. and international subsidiaries’ operations, including our
growth platforms, Evernorth HealthSM Services and Cigna HealthcareSM.
This report:• Is aligned to the Sustainability Accounting Standards Board (SASB) Managed Careand Professional and Commerical Industry Standards.
• Is reported in accordance with the Global Reporting Initiative (GRI) Standards.
• Leverages the recommendations of the Task Force on Climate-related
Financial Disclosures (TCFD).
• Serves as our Communication on Progress as a member of the United Nations (UN)Global Compact.
The Cigna Group reports on our ESG performance on an annual basis. Current and pastreports, along with our CDP(2) Climate Change and Water Security responses, are available
here. For more information or questions, please contact ESGteam@TheCignaGroup.com.

Note on Forward-Looking Statements
This report contains forward-looking statements (within the meaning of the Private Securities Litigation Reform Act of 1995) that are subject to risks and uncertainties. Forward-looking
statements are based on current The Cigna Group expectations and projections about future trends, events and uncertainties. You may identify forward-looking statements by the use ofwords 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. 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. Actual results may differ from those set forth in theforward-looking statements due to a variety of factors, including those described in The Cigna Group Annual Report on Form 10-K for the year ended December 31, 2022, and other
The Cigna Group filings with the U.S. Securities and Exchange Commission, available on the Investor Relations section of www.TheCignaGroup.com. The Cigna Group 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. This reportaddresses a multitude of topics to meet the requests and interests of the wide range of The Cigna Group stakeholders. Due to the varied interests of these groups, this report includes
certain information that The Cigna Group believes is not material to the company as such term is defined under applicable securities laws. Accordingly, the inclusion of information inthis report should not be construed as a characterization regarding its materiality or significance for any other purpose, including for purposes of applicable securities laws.

1
2

We previously referred to our corporate responsibility and ESG approach as Cigna Connects. We are now using the term "ESG" to refer to our efforts in this area.
CDP is a not-for-profit charity that runs the global disclosure system for investors, companies, cities, states, and regions to manage their environmental impacts: cdp.net
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A Message from Leadership
DAVID M. CORDANIChairman andChief Executive Officer
The Cigna GroupThe Cigna Group has roots that can be traced back more than 200 years—and has
an unparalleled track record in our industry of making a positive impact in the
lives of people around the world. Today, our more than 70,000 colleagues continue
to work tirelessly with our customers, clients, partners, and communities to deliveron our evolved mission: to improve the health and vitality of those we serve.
It’s this steadfast focus on our mission that fuels
The Cigna Group colleagues, by leading, partnering,
innovating, and serving our stakeholders throughsustained geopolitical and economic disruption.
With the Public Health Emergency winding down,
The Cigna Group continued efforts in 2022 to lead for
those we serve. We worked closely with health careproviders and hospital systems, and we partnered withlocal organizations in communities in need to educate
individuals and help support expanded access to care.

DONNA F. ZARCONE
Chair, Corporate
Governance Committee
The Cigna Group Boardof Directors

The devastating war and humanitarian tragedy in Ukraine
is difficult to fathom, and The Cigna Group stands proudlywith the people of Ukraine. We supported Ukraine withdonations in the region, as well as crisis and counselingsupport for regional customers. We also partnered with
the United Nations, a client we are privileged to serve, tosupport their employees as they worked tirelessly to help
people in Ukraine. In addition, our colleague volunteers

from The Cigna Group helped refugees as they fled toother countries. Our great hope is that this war will cometo an end peacefully and swiftly.
In last year’s report, we introduced you to our new ESG
framework—one that meets the needs of our many
stakeholders today, and in the future. This year, withoversight by The Cigna Group Board of Directors, we havebuilt on that framework by developing a strategic road map
to deliver on our ESG vision: to transform the ecosystemof health into one that is well functioning, sustainable,
accessible, and equitable—advancing better health for all.
This vision guides us as we continue to push ourselves to
do more in the years ahead in each of the four pillars thatcomprise our ESG framework: Healthy Society, Healthy
Workforce, Healthy Environment, and Healthy Company.
The following are a few highlights of our 2022 efforts withineach pillar.

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Healthy Society

Healthy Workforce

We believe that all individuals should have access tohigh-quality and affordable health care, and we arecommitted to fostering an ecosystem of health thatsustains future generations. We demonstrate thatcommitment through efforts such as using a digitalfirst mindset, working to ensure affordable access toprescription drugs, and addressing social determinantsof health (SDOH) in order to reduce health disparities.

The only way we are going to further our mission is torecruit, retain, develop, and promote the best talent.
The COVID-19 pandemic demonstrated that well-being
is more than physical and mental health alone; it’s the
pursuit of vitality—or dimensions of health, strength,and energy. To further support the vitality of ourworkforce and their families, we expanded our caregiverprogram in 2022 in the United States and doubled thenumber of employee assistance program (EAP) visits
for coworkers and their families, with up to 10 free,
confidential counseling sessions per year.

For example, we are working to eliminate healthdisparities relative to diabetes through a multifaceted
approach, including enhanced training for our clinicalcolleagues, patient education, monthly caps on insulin
costs, and support for community health workers.
In addition, our charitable giving is focused on healthequity and organizations that address SDOH, helping
to create more vibrant, healthier, and more equitablecommunities. In 2022, The Cigna Group Foundation
funded more than 150 grants, and 90% supported efforts
that addressed SDOH.
Looking to the future, in 2022, we announced amulti-year collaboration with VillageMD, a leading providerof value-based primary care services. This partnershipis aimed at better connecting our Evernorth HealthServices with physicians, accelerating value-based carearrangements, and broadening access to medical andbehavioral services. By doing so, we help employers
save money while getting patients to the right carein the right setting at the right time.

We are also proud of the progress we have made in thelast year to improve diversity, equity, and inclusion (DEI)
for our workforce and workplace. We continued to deliveron our DEI goals and efforts, and we publicly shared our
DEI scorecard. This data has been informing the areas
where we need to invest greater time and resources.
For example, we have a long-standing commitment tofair pay practices and last year, our externally conducted
pay equity analysis showed that our female colleagues
earned more than 99 cents for every dollar earned byour similarly situated male colleagues. We are on trackto achieve our goal to reach gender parity in ourleadership pipeline by 2024. Recognizing our hard
work, we are encouraged by the number of awards
we received for our progress in 2022, including a#14 ranking on Fair360’s (formerly known as DiversityInc)
Top Companies for Diversity, a 10-place jump forward
over the prior year.

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Well-being is morethan physical and mental
health alone; it’s the

pursuit ofvitality.

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Healthy Environment

Healthy Company

There is an intrinsic connection between human healthand environmental health, and we know our stakeholders
are counting on our company to further reduce emissions
and ensure long-term sustainability.

Strong governance and ethical business practices are acornerstone of our company. That is why all our colleagues
around the world are guided in their every action by our
Code of Ethics and Principles of Conduct. Along with
our values, these guide our decisions both in actual letter,as well as intention.

In 2022, we joined RE100, a global renewable energy
initiative, and committed to source 100% renewableelectricity by 2030. We continued our work to achievecarbon neutrality for our operations by 2040 and to reduce
Scope 1 and 2 greenhouse gas emissions by 50% by 2030.
We are currently working to expand our assessment of
our Scope 3 greenhouse gas emissions and a timeline fordefined science-based reduction targets. These steps build
on a number of environmental investments in the areasof sustainable buildings, renewable electricity, water,and other innovations across The Cigna Group.
We also are making more health care services available
where and when people need them. Our MDLIVE®
platform provides virtual primary care, mental healthcare, urgent care, and more from the comfort, privacy,
and convenience of wherever the individual prefers.
With this platform, we also recognize the growing
opportunity we have to further reduce greenhouseemissions with every use, including the environmental
footprint generated by individual travel to care.

To ensure long-term business sustainability, we havecultivated a set of businesses of different sizes and scale,maturity, and rates of growth which individually—andby working together—position our company to deliveron our mission. We updated our company name to
The Cigna Group, reflecting the breadth of our businesses
and relationships across our two growth platforms, eachleading the way in the defining health issues of our time:
access to quality, affordable medical benefits with Cigna
Healthcare and the provision of a range of health solutions
and pharmacy benefits with Evernorth Health Services.
Finally, our focus on strong governance is evident at
every level. Our ESG strategy and efforts have ultimate
oversight by The Cigna Group Board of Directors, andwe are pleased that our commitment to diversity andgovernance is reflected in our Board composition.
In 2022, we exceeded the S&P benchmarks on medianage, tenure, gender, and ethnic diversity.

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At The Cigna Group, we approach the world’s healthchallenges with optimism, urgency, and a confidence
that we will continue to make a positive impact.
Our efforts throughout 2022 earned our company
the #1 ranking for corporate citizenship among
the health care industry by JUST Capital and CNBC,a direct reflection of the hard work of our colleagues
around the world, who remain relentlessly focusedon delivering on our mission every day.
Our work will never be done, but with clarity of focus,
we will expand on our 2022 accomplishments in theyears ahead and build a healthier world for all.
Sincerely,

DAVID M. CORDANIChairman and Chief Executive Officer
The Cigna GroupDONNA F. ZARCONE
Chair, Corporate Governance Committee
The Cigna Group Board of Directors

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About The Cigna Group$180.5 billion

Our Mission

total revenues

Improve the health andvitality of those we serve.

2 million+

Our Vision

178 million+

relationships with health careproviders, clinics, and facilities

A better future built on
the vitality of every individualand every community.

customer relationships(3)70,000+employees committed to changing
people’s lives for the better~30

countries andjurisdictions served;
headquarteredin Bloomfield,
Connecticut, U.S.A.

As of December 31, 2022

Our Values
Our values guide how
we work together; serve
our customers, patients,
clients, and communities;
and deliver on our mission.

We care deeply
about our customers,
patients, and coworkers.

We partner,
collaborate, andkeep our promises.

We innovate
and adapt.

We act withspeed and purpose.

We create a better
future—together.

See our 2022 Annual Report and Form 10-K for more information.
3

Effective January 1, 2023, the way we calculate pharmacy lives has been updated to reflect actual customer-filledprescriptions through Inside Rx. Previously, these lives had been estimated based on active customers over a periodof time. The total number of customer relationships as of December 31, 2022, has been updated to reflect this change.
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Our ESG Vision,
Framework, and Strategy
Our ESG vision is to transform the ecosystem of healthinto one that is well functioning, sustainable, accessible,
and equitable — advancing better health for all.

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Our Priority ESG Focus Areas
Healthy Society• Sustainable health care
• Product service and quality• Health equity• Community resilience

Our ESG vision underscores our enterprise mission to
improve the health and vitality of those we serve and is anextension of our values (see page 8). Our commitment tothis vision guides us in our multidimensional value-creation
framework and strategy as we strive to meet the needsof our many stakeholders.
Starting in 2021 and continuing into 2022, we evolved our
ESG framework. To guide that evolution, we engaged an
independent consultant to perform an updated ESG priority
assessment to identify the ESG issues that matter most to
The Cigna Group business and our stakeholders and that

represent areas where we have the greatest capacity totake action and make a positive impact. Based on the
results of that assessment, we prioritized our ESG focus
areas and organized them under four connected pillars,
highlighted to the right. We intend to review these focus
areas annually and conduct a formal priority assessment
every few years.
In 2022, we continued to evolve our ESG strategy byworking with subject matter experts throughout thecompany to develop additional programmatic initiatives
to drive our ESG vision forward over the next few years.

Healthy Workforce• Employee health, safety, and vitality• DEI within our workforce• Human capital development

Healthy Environment• Climate change and emissions• Sustainable operations

Healthy Company• Leadership and accountability• Business ethics and compliance

We also identified key performance indicators (KPIs) to disclose in our future reports
for each of our ESG focus areas to demonstrate our progress. A summary of this workfor each focus area is denoted with a compass symbol throughout this report.

• Data protection• Responsible supply chain

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ESG Governance and Oversight
To deliver on our ESG vision and strategy, we leverage arobust governance structure that promotes oversightand accountability. The Cigna Group Board of Directors(the Board) has ultimate oversight responsibility for thecompany’s ESG strategy and initiatives and has delegatedcertain responsibilities to its committees as described
below. Our ESG focus areas are aligned to the applicableboard committee(s) in the table at right.

Corporate Governance Committee

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ESG Focus Area

Audit
Committee

Compliance
Committee

Corporate GovernanceCommittee

People Resources
Committee

Business ethics and compliance

Not involved

Involved

Involved

Not involved

Climate change and emissions

Not involved

Not involved

Involved

Not involved

Community resilience

Not involved

Not involved

Involved

Not involved

Involved

Involved

Not involved

Not involved

Data protection• Ensures the Board adheres to strong board
governance practices generally

DEI within our workforce

Not involved

Not involved

Not involved

Involved• Monitors the company’s policies, practices,
and initiatives related to corporate responsibility
and environmental sustainability

Employee health, safety, and vitality

Not involved

Not involved

Not involved

Involved

Health equity

Not involved

Involved

Not involved

Not involved

Human capital development

Not involved

Not involved

Not involved

Involved

Leadership and accountability

Not involved

Not involved

Involved

Involved

Product service and quality

Not involved

Involved

Not involved

Not involved

Responsible supply chain

Not involved

Not involved

Involved

Not involved

Sustainable health care

Not involved

Involved

Not involved

Not involved

Sustainable operations

Not involved

Not involved

Involved

Not involved• Reviews and approves our annual ESG report

Audit Committee• Oversees cybersecurity• Oversees our disclosure controls

Compliance Committee• Oversees health care regulatory requirements
governing our business operations• Oversees ethics, data security, and privacy

People Resources Committee• Oversees human capital management matters,
including pay equity and DEI

A specific ESG focus area has not been delegated to the Finance Board Committee. However, the entire Board has oversight responsibility for our ESG strategy and initiatives.

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At the management level, our ESG Advisory Committee
comprises several senior leaders from across the company,
including leaders from each of our growth platforms,
to support our ongoing commitment to environmental
stewardship, a sustainable and equitable health care system,
our employees, corporate social responsibility, and corporate
governance. Ultimately, this committee, with support from
our ESG team, seeks to further integrate our ESG vision
throughout the enterprise strategy and operations of The
Cigna Group. In 2022, we expanded our ESG team to include
specific environmental sustainability expertise as we maturein progressing our climate-related commitments.

Our ESG Governance Model

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PRESIDENT AND CEO
Capital expendituresand investments

ESG EXECUTIVE SPONSORS (ELT)ESG ADVISORY COMMITTEEESG PERFORMANCE METRICS

Snapshot of Recent ESG Recognitions
Member of Dow Jones
Sustainability Index for both theWorld and North America, marking
the sixth straight year that The Cigna
Group has been named to the indices

Top 1% in EcoVadis, improving
to a Platinum Medal sustainability
rating over Gold in 2021

BOARD OF DIRECTORS
Oversight of strategy
and initiatives

H E A LT H Y C O M P A N Y

Upgraded to AA in MSCIESG Ratings, representing
industry leadership

Ranked #14 on Fair360’s(formerly known as DiversityInc)
Top 50 Companies for Diversity,
a 10-place jump forward from 2022

Named a 2022 Best Places to Work
for LGBTQ+ Equality by the Human
Rights Campaign Foundation

Named one of America’s Most
JUST Companies for the third year
by JUST Capital and CNBC, including:• #1 in the Health Care Providers industry• #16 overall in the JUST 100

Honored by Business Groupon Health as Best Employer
for Health and Well-being• #1 in our industry for living
wage, human rights, customer
privacy, customer treatment,
transparent communication,and sustainable materials(4)4 These represent JUST Capital issues and metrics where The Cigna Group scored at the top of the Health Care Providers industry.

ESG CORE TEAM AND KEY MATRIX PARTNERS

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HealthySociety
We advance better health for all. Building a wellfunctioning, sustainable, accessible, and equitable
health care system requires understanding andaddressing social determinants of health (SDOH)
and improving medical quality and access while
lowering health risks, promoting preventive healthinterventions, and coordinating all aspects of care.

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Core to our approach to sustainable health care is influencing
how patients access care and connect to the highest-quality
physicians, medications, and optimized care modalities—with
a focus on value. We work toward this commitment throughour two growth platforms within The Cigna Group:

Sustainable
Health Care
We are committed totransforming how careis accessed, delivered,and coordinated to drive
better health outcomes
and affordability for ourclients and customers.

• Evernorth Health Services includes a broad
range of coordinated and point solution healthservices and capabilities in pharmacy benefits,
home delivery pharmacy, specialty pharmacy,
distribution, and care delivery and management
solutions, which are provided to health plans,
employers, government organizations, andhealth care providers.
• Cigna Healthcare includes our U.S. Commercial,
U.S. Government, and International Healthoperating segments, which provide
comprehensive medical and coordinatedsolutions to clients and customers.
Through these businesses, we are taking action
to meaningfully improve affordability, access,and health outcomes by:• Creating high-performing networks that drive quality
and improve access (page 14)• Lowering the cost of prescription and specialty drugs (page 18)• Guiding customers to optimal sites of care (page 19)• Tackling the most-complex, highest-cost healthneeds and conditions (page 20)

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Creating High-Performing
Networks that Drive Quality
and Improve AccessWe design medical, behavioral, and pharmacy networks
that drive patients to top-performing clinicians who
recommend more clinically effective treatments andmedications, thereby driving affordability and value.

Investing in Value-Based Care
Value-based care models are health care models
through which we pay health care providers basedon health outcomes and quality metrics instead ofbased on the volume of care and services delivered.
Outcome data is measured on specific interventions
to highlight both clinical and cost impacts.

In 2022, we entered into a multi-year strategic collaboration
with VillageMD, one of the largest independent primarycare groups in the United States with excellence invalue-based care. With this collaboration, we will
accelerate a value-based care model that allows patients
to move seamlessly between virtual, digital, and in-person
physicians. It will help reduce health care costs and makesure patients receive the appropriate care in the most
optimal setting and at the right time.

As part of our existing value-based model, Cigna Collaborative Care®, we have the following as of the end of 2022:~670

collaborative
care programs

5

~240

accountablecare
organizations(5)~126K

primary careproviders invalue-based
arrangements~92K
specialty
providers

3M+

customers
who received
value-basedcare throughthese programs~75%

of Medicare
Advantage
customers invalue-based
arrangements

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Supporting our Medicare
Advantage Customers
We continued to expand our Medicare
Advantage program geographically in 2022,
adding three states and 108 counties that
represent nearly 30% addressable market
growth over 2021. We announced that we areadding another two states and 106 counties toprepare for our 2023 plan year. Here are a couple
ways we supported our Medicare Advantage
customers in 2022 (see also page 19):
• Expanded transportation benefit –We provide eligible customers with a sameday transportation benefit to go to doctor
appointments or the pharmacy. With theextreme heat in 2022, we expanded this toprovide rides to community cooling centers forcustomers to safely find relief from the heat at
no extra cost. In the winter, we also provided
this benefit to customers experiencing heating
system failures during cold weather.
• Meal delivery – We provide 14 days of freemeal delivery after a hospital stay for eligible
customers. In 2022, we delivered approximately
900,000 meals to more than 45,000 people.

As defined by the Centers for Medicare & Medicaid Services, accountable care organizations are groups of doctors, hospitals, and other health care providers that come together voluntarily to give coordinated high-quality care to their Medicare patients.

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Expanding Access and Removing
Barriers to Behavioral Health Care
We are an industry leader in recognizing the link between
physical and behavioral health and viewing health holistically.
In 2022, our Evernorth Research Institute findings—
showing lower medical and pharmacy costs associatedwith outpatient behavioral health treatment following
a medical diagnosis—were published in the Journalof the American Medical Association Network Open.
Recognizing the importance of this link, we continued
to take the following approaches in behavioral health care:
Increasing accessibility of behavioral health care
In 2022, our network of behavioral health providers grew bymore than 30% to include more than 300,000 mental healthand substance use providers—doubling over the past four years.
Our virtual care network grew nearly 100% to include morethan 163,000 virtual behavioral health providers. Virtual care helps
customers overcome potential barriers related to mental healthstigma, scheduling, privacy, and in-person accessibility.

Behavioral
Care Pilot
with MDLIVE

Addressing health equity in behavioral health care

Driving better health outcomes

We increased our network to include providers who
support cultural and race-related counseling by
approximately 21% in 2022. Plus, to expand behavioral
health care access, we established partnerships withseveral virtual ancillary providers,(6) most of whom
have a focus on vulnerable populations.

Mental health treatment in tandem with oncology
treatment can help improve cancer survival.(7)We created an oncology-specific behavioral healthprovider network powered by our collaborative
relationship with the American Psychosocial
Oncology Society. Our behavioral health providers
have the opportunity to complete an on-demand,
30-hour course to receive an oncology specialty
designation within our behavioral health network.
This designation will help us connect cancer patientsto specialists who have the expertise and experience
to help them achieve whole-person health and wellness.

Using data-informed insights to improve behavioral
health care
In 2022, we created and tested new predictive models,
including an autism early identification model that allows us
to identify and conduct proactive outreach to families with achild likely to be diagnosed with autism spectrum disorder.
Through this early intervention, we provide families witheducation and resources during a time when they may
have the most questions, and we help them navigate
medical, behavioral, pharmacy, and community resources.

6
7
8

Ancillary providers are large virtual provider groups, typically offering services in multiple states or nationwide.
Some ancillaries provide general mental health and/or substance use services, while others may specialize incondition-specific care (e.g., eating disorders).
Berchuck JE, Meyer CS, Zhang N, Berchuck CM, et al. "Association of Mental Health Treatment With Outcomesfor US Veterans Diagnosed With Non-Small Cell Lung Cancer." JAMA Oncology, 2020 Jul 1;6(7):1055-1062. doi:
10.1001/jamaoncol.2020.1466. https://pubmed.ncbi.nlm.nih.gov/32496507/
California Joins States Trying to Shorten Wait Times for Mental Health Care | HealthLeaders Media,
2021-CCBHC-Impact-Report.pdf (thenationalcouncil.org)

In 2022, we launched a digital-first, virtual-led, data-informed behavioral care mobile app to pilot with our approximately 1,400 MDLIVE behavioral
health clinicians. The app allows patients faster access to behavioral care where and when they need it. Studies show that the average total time
to care for behavioral health can range from 6 weeks to 3 months.(8) During the first four months of the pilot, we observed a shorter total time to care.
Refining and building upon capabilities developed through this pilot will position us to deliver more personalized, flexible, digital-first, and virtual-led
experiences for additional health conditions while offering personalized recommendations for improved health outcomes. This pilot is an exampleof how several components of The Cigna Group—behavioral health, digital and analytics, and care delivery—work together to serve our customers.

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Managing Substance Use Disorders
When it comes to managing substance use disorders,
our objectives are to:• Encourage customers to make behavioral changes
and take the steps necessary to initiate and engage
in outpatient behavioral treatment• Reduce readmissions to higher levels of care
• Provide support to customers and family members
seeking help for a substance use disorder
Through the use of predictive modeling, we identify
high-complexity cases and conduct proactive outreachthrough our case managers who specialize in substanceuse disorders. The case managers coach customers
throughout their recovery journey and provide support,such as exploring outpatient treatment and coordinating
care with primary care doctors. We have a dedicatedphone line for substance use disorders, along with 24/7
availability through our clinical after-hours crisis line.

For certain patients struggling with opioid use disorder,
we support medication-assisted treatment, which can
include a combination of therapy and medications to
help opioid use disorder and/or pain management, andcognitive behavioral therapy to reduce and manage painwith fewer or no opioids. Other program components
include proactively reaching out to high-risk customers,
collaborating with providers to ensure continuity of care,and engaging with customers to complete behavioral
health treatment for pain management. We continue
to leverage interventions as part of the Express Scripts®
Advanced Opioid Management program.(9) In 2022,
we continued to expand our virtual opioid use disorderprograms in our behavioral health network.
In 2018, we set a goal to reduce opioid overdoses by
25% among customers in targeted U.S. communities(Chicago, Connecticut, Mid-Atlantic, New York/New Jersey,
and Philadelphia) by 2021.(9) While we fell short of that goal,
we continued to track our efforts and reached a 30%
reduction in opioid overdoses by the end of 2022.

Given opioid overdoses in the United States remained
high in 2022, this is a noteworthy achievement. In 2023,
we are continuing to scale the initiatives that took
place as part of this program across additional markets
throughout the enterprise.
In addition to the interventions identified above, ourown pharmacies, as part of the Express Scripts professional
practice of pharmacy, regularly review and monitor opioids
and other medications of interest. For example, all opioidprescriptions are routed to a dedicated group of trained
pharmacists who review them against Centers for
Disease Control and Prevention (CDC) Clinical Practice
Guidelines and Drug Enforcement Administration (DEA)
red flag identification protocols. This includes, whereclinically indicated:• Engaging prescribers and patients to ensure safe
and appropriate therapy• Ensuring appropriate dosing and supply• Checking for medication combinations that may
indicate inappropriate use• Reviewing individual state prescription monitoring
databases

We reached a30%

reduction in
opioid overdosesby the end of 2022.

• Monitoring reported prescription loss and earlyrefill/overutilization patterns
Additionally, when we are filling a prescription fora patient who is receiving a higher dose of opioids,
our pharmacists review the availability of naloxone(10)and ensures the patient has access to it.
9 Please see page 24 of our 2021 Corporate Responsibility Report for more details.
10 Naloxone is a medicine that rapidly reverses an opioid overdose.
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Supporting Youth Mental Health and Families
Attention on the state of mental health in the United States
is arguably higher than ever. A recent Evernorth analysis ofcommercially insured customer data shows there is reason
for concern—particularly when it comes to the health andsafety of children and adolescents. Suicidal ideation andsuicide attempts exceed pre-pandemic levels across all age
groups, but the largest increase occurred in those aged 17
and under. Our data shows a 14% increase in suicide-related
diagnoses in children and adolescents, accounting for 35%
of all customers with these diagnoses.(11)We saw similar concerns in a 2022 study we commissioned
with Economist Impact to better understand the mental
health impacts of the pandemic for teens and the ripple

effect for parents, families, and communities. Nearly 80%of the 1,100 parents surveyed reported seeing new orincreased signals of potential mental health issues fromtheir teens, including anxiety, depression, behavioral issues,
and/or increased problems with social interactions.
Through Evernorth Health Services, we have a suite ofbehavioral coaching and programs to help support bothyouth in need of behavioral health interventions related tomental health, substance use, autism, and eating disorders
and their loved ones. Through these programs, we aim
to connect youth to services and educate and empower
parents to navigate and access resources.

As of the end of 2022, we have:~172,000

behavioral health providers
treating children/adolescents;~27,000 providers added
to the network in 2022,
a growth rate of nearly 19%~2,700facilities treating
children/adolescents;~200 facilities added
in 2022, a more than
8% growth rate

~138

Child and AdolescentCenter of Excellence
locations, providing
quality, affordable care

Contractedwith a national pediatricbehavioral health provider
that provides virtual support
for kids, teens, and parents(and expanded nationally
as of early 2023)

11 Nemecek D. "American Youth Increasingly at Risk of Suicide." Evernorth Health Services. February 8, 2023. https://www.evernorth.com/articles/youth-suicide-prevention-understanding-key-factors
12 Cost savings were determined from an internal analysis of 2021 client data.
13 Results from our care delivery business were obtained through an internal study conducted in 2022, which utilized 2021 data that analyzed the impact of the integrated health center, coaching, and case management clinical team.

Specific to autism, we announced a first-of-its-kindpartnership in 2022 with Behavioral Health Center of
Excellence, a data-driven health services accreditor. The
partnership allows us to collaborate on developing quality
performance measures that will help people with autism
and their caregivers assess the quality of their treatment.
We also invest in youth mental health through ourcharitable giving efforts. For example, The Cigna Group
Foundation supported the Covenant House in Missouri,
which welcomes LGBTQ+ youth who may be runaways,
trafficked, or at risk or who may be experiencing
homelessness. The organization has therapists trained toaddress traumatic situations that many LGBTQ+ youth face,such as bullying, discrimination, rejection, and violence.
We also partnered with Bright Star Community Outreachto improve mental health for kids in Chicago. And Healthier
Kids For Our Future® (see page 31) prioritizes the mental
health and emotional well-being of our children.

Illustrating the Importance of Integration
In early 2023, we released a study, conducted by Aon plc,that finds triple integration of medical, pharmacy, andbehavioral benefits resulted in lower health care costs for
employers and improved health outcomes. We have seen
this play out in our care delivery business, where we saw
cost savings through our integrated health center, coaching,and case management services at $942 per member per
year.(12) And we saw a 35% reduction in inpatient admissions
among our patient population that used our integrated
health center, coaching, and case management services.(13)
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Lowering the Cost of Prescription
and Specialty Drugs
We increase the value of every dollar spent onpharmaceuticals by procuring drugs at the lowest
price, driving appropriate clinical interventions,and moving to cost-effective, clinically appropriate
alternatives when available.
One way we do this is through biosimilars, which
are biological products highly similar to, and with noclinically meaningful differences from, existing biologics.
In 2022, we added insulin biosimilar SEMGLEE® to ourExpress Scripts National Preferred Formulary, and in 2023,
we will add preferred biosimilars for HUMIRA®, one of
the most widely used biologic specialty medications
that treats conditions such as rheumatoid arthritis,
Crohn’s disease, and psoriasis.
We also address cost and accessibility of genetherapies with our Embarc Benefit Protection® program.
Gene therapies can be life-changing for patients withrare diseases but can also be incredibly expensive.
Through Embarc Benefit Protection, we help shield
health plans and customers from the high cost of
breakthrough gene therapy drugs.

Through the Patient Assurance Program,patients taking insulin saved

In 2022, an average of approximately 5.8 million customers
were included in the program, and we added two genetherapies to the program:• ZYNTEGLO® (betibeglogene autotemcel): Used for ablood disorder known as beta thalassemia in patients
who cannot make enough beta-globin and require
regular red blood cell transfusions at a one-time cost of$2.8 million. ZYNTEGLO has the potential to free patientsfrom chronic transfusions, helping them eliminate
hundreds of hours each year managing the disease.
• SKYSONA® (elivaldogene autotemcel): With a one-timecost of $3 million, this gene therapy slows the progressionof early, active cerebral adrenoleukodystrophy(CALD) in patients 4–17 years of age. CALD is a rareneurodegenerative disease that can lead to progressive,
irreversible loss of neurologic function and death.
Through our pharmacy benefits manager, Express Scripts,
we negotiate with pharmaceutical manufacturers to lower
the cost of drugs for our clients and patients. Overall,savings negotiated by Express Scripts in 2022 helped keep
average out-of-pocket costs for a 30-day prescription toless than $15 for patients with coverage in the commercial
market, less than $9 for Medicare beneficiaries, and lessthan $1 for Medicaid beneficiaries.(14)more than $18 million
with point-of-sale discounts in 2022 alone.

14 Express Scripts. “Delivering Value & Affordability to Consumers.” 2023. https://express-scriptsfacts.com/key-topics/
delivering-value-affordability-to-consumers/. Averages based on Express Scripts entire book of business.
15 Gilroy C. “Close Management of Diabetes Medications Lowers Medical Costs.” Evernorth Health Services. June 16, 2022.
https://www.evernorth.com/articles/affordable-cost-of-diabetes-medication-can-improve-health-outcomesMore specifically, Express Scripts was among the first toaddress costs for insulin for patients with diabetes throughthe Patient Assurance Program, where patients spend no
more than $25 for a 30-day supply. Patients taking insulin
saved more than $18 million with point-of-sale discounts in
2022 alone, part of more than $45 million in member savingson insulin since the program launched in 2020.(15)Also, as a result of successful pilots in 2022 and the years
preceding, we recently announced new products andservices that will be available starting in summer 2023:• New Copay Assurance™ plan (CAP) ensures consumers
pay less out of pocket by capping copays on prescription
drugs: no more than $5 for generics, $25 for preferred branddrugs, and $45 for preferred specialty brand drugs.
• Introduction of a fully transparent pricing model,
ClearCareRx™, a simpler option in which employers,
health plans, and government employer clients pay
exactly what Express Scripts pays for drugs.
• Launch of IndependentRx Initiative to expand rural
health care access through partnerships with independent
pharmacies. The new initiative will offer increased
reimbursement opportunities and additional care services torural independent pharmacies—and create an Independent
Pharmacy Advisory Committee to expand the role of rural,suburban, and urban pharmacies in the health care system.
The new solutions will increase access to affordable
medicines and drive greater transparency and predictability.

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Guiding Customers
to Optimal Sites of Care
We are working to transform and improve how careis coordinated, accessed, and delivered. This includes
navigating patients to virtual, digital, and in-homealternatives, which improve access through greater
ease, speed, and trust-based interactions. This enhanced
access improves identification, diagnosis, and managementof critical care needs.

Virtual
In 2022, MDLIVE announced the next evolution of
our rapidly growing virtual primary care program toenhance support for patients with chronic conditions.
The program will initially target patients with hypertension.
Their MDLIVE primary care doctor will work with them todevelop a personalized care plan that includes condition
management and lifestyle goals, lab tests, medication
management, and any necessary referrals to other healthproviders. In between regular visits, their care team will
track their progress with remote monitoring throughconnected devices, such as blood pressure cuffs andblood glucose monitoring devices.

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In-Home

DigitalWe launched a program to offer home visits at no
additional cost to Medicare Advantage customers
living with multiple chronic health conditions. The newprogram addresses common barriers to care faced by older
Americans, including chronic conditions, limited mobility,
and transportation issues. Additionally, in-home care forchronic kidney conditions is now(16) available to more of ourMedicare Advantage customers through Monogram Health,a The Cigna Group Ventures portfolio company. Separately,
we saw 96% patient satisfaction in 2022 from our Home
Health Management program, where we authorize andcoordinate medically appropriate, home-based nursing
and therapies.

An example of how we’re moving to digital careis the addition of five app-based programs to ourEvernorth Digital Health Formulary to help people better
manage their sleep issues, anxiety, alcohol and opioid
use disorders, and inflammatory conditions. We also
launched a new platform for both psoriasis and eczema
from Zerigo Health, a Cigna Ventures portfolio company.
Zerigo’s solution will be offered as a pilot program throughour Digital Health Formulary. In a crowded digital healthmarketplace, our Digital Health Formulary is a clinically
based platform of verified, credible health apps designed
to help people achieve their health goals.

Driving Innovation through The Cigna Group Ventures
The Cigna Group Ventures is our strategic venture fund and wholly
owned subsidiary with a mission to be a catalyst for health careinnovation. We committed an additional $450 million(17) to the fundin February 2022 to drive continuous health care transformation,
innovation, and growth.

16 As of February 7, 2023.
17 In 2018, The Cigna Group committed $250 million to The Cigna Group Ventures to fund investments in promising
startups and growth-stage companies that are making groundbreaking progress in three strategic areas: digital health/experience, insights/analytics, and care delivery/enablement.
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Tackling the Most-Complex,
Highest-Cost Health Needs
and Conditions
We focus on conditions that account for the majority ofhealth care spend—such as diabetes, oncology, behavioral,
musculoskeletal, and rare and orphan diseases—creating
coordinated care pathways for patients that reduce waste
and effectively manage the entire health care journey,
supporting better health outcomes.
For example, in 2022, we:• Launched a new service to improve healthoutcomes for patients with complex cancers.
The service connects patients and their community
oncologists with cancer sub-specialty experts at
National Cancer Institute–designated centers.
In a pilot with select Cigna Healthcare customers,
85% of eligible community oncologists and theirpatients participated in the program by having
their treatment plans reviewed by expert oncologists
in the PinnacleCare network of medical centersof excellence across the country. Among thereviewed cases, 40% of patients benefited fromrecommendations for alternative tests and therapy
choices based on the newest advancements inresearch and treatment innovations.

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We are committed to building on our
momentum in sustainable health care.
For example, we plan to:• Unveiled Cigna PathwellSM, a concierge service
that creates a personalized end-to-end health journey
for patients living with high-cost health conditions andstreamlines benefits management for their employers.
Pathwell Specialty supports patients with complex
or rare conditions, and Pathwell Bone & Joint
addresses musculoskeletal conditions. Both integrate
our high-performing provider networks and medical
benefits management with analytics, clinical expertise,and personalized digital support.
Learn more about our work in diabetes on page 27.

• Continue to develop and implementtargeted customer initiatives toimprove health screening rates andsubsequent health outcomes• Positively impact oncology patients’
engagement, health outcomes, andcosts by identifying cancer earlier
and using genomic testing to avoid
unnecessary, ineffective treatment
WHERE WE’RE
GOING INSUSTAINABLE
HEALTH CARE

• Disclose our pharmacist completion
rate of specialized clinical training• Continue to develop and implement
initiatives to engage patients throughour Accredo® Therapeutic Resource
Centers, and report our progressof increasing average medication
adherence for our integrated multiple
sclerosis (MS) population and thepercentage of MS patients engaged
within 180 days of their first fill
• Demonstrate thought leadershipby sharing the number of peerreviewed studies published and/or
presentations at conferences related
to our Accredo specialty areas

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Product
Serviceand Quality
The Cigna Group portfolio
of offerings solves diverse
challenges across thehealth care system.

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We offer a differentiated set of pharmacy, medical,
behavioral, dental, and supplemental products andservices. The experiences of our customers and clientsare critical to protecting and improving our customers’
health and vitality, as well as enabling our business strategy
and being a source of competitive differentiation. For thesereasons, we manage ongoing, real-time feedback loops
across audiences, business lines, and channels. The insights
we glean from these programs inform the actions wetake and the investments we make in product, service,and quality improvements across the enterprise.

Maintaining Quality
We are committed to providing customers with theright care at the right time in the right place. We invest
substantial resources in a broad scope of quality programs,
and our commitment to quality has been recognized bynational external accreditation organizations and throughnumerous industry and community awards. Our integrated
Quality Management Governing Body oversees the
Quality Programs for The Cigna Group and its operating
subsidiaries, and it annually evaluates the performanceof Quality Programs through an assessment of relevant
indicators and activities. The results of this analysis drive
improvement throughout the organization.
The responsibility for maintaining a robust and successful
Quality Program extends beyond our National Quality
team and includes collaboration and support frommultiple operational areas across the enterprise.

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We use the Healthcare Effectiveness Data andInformation Set® (HEDIS®)(18) to evaluate performanceand identify opportunities for improvement using amarket-based approach.

Customer Experience
The Cigna Group uses a variety of metrics to track,evaluate, and improve customer satisfaction, including:• The Relationship Net Promoter Score (rNPS),
which tracks our customers’ overall experience
with The Cigna Group products and services• The Transactional Net Promoter Score (tNPS), which
tracks customer satisfaction with the service experience
across human-assisted and self-service channels• Customer feedback generated outside of our NPS
surveys, including online comment cards, social media
engagement, call monitoring, app store reviews, and more

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Our Commitment to Quality outlines our customers’
rights and responsibilities, along with how to share any
concerns or complaints with us. Each customer appeal
or grievance that is raised with our escalated call teamor through executive office complaints is reviewed by
the Satisfaction Organization. This team reviews thecause of the escalation as well as all actions taken toward
resolution through case reviews, call reviews, and endto-end audits. We do this to gain a better understandingof opportunities for improvement and to prevent similar
experiences for future customers. We maintain all records
of formal complaints raised with the executive office toreport to compliance, the state, and other legal entities
for audits and examinations.
The Executive Operating Committee of The Cigna Group,comprising C-suite executives and senior leaders, is
responsible for oversight of our customer experience.
The committee receives regular updates on our progressagainst a defined set of objectives in the areas ofengagement, efficiency, value generation, and satisfaction.

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Accredo Cares
For patients with bleeding disorders, wehave a dedicated website, hemophilia.com,
that provides several educational resources.
Topics cover treatment options, venous access,emergency care, guides for coaches andeducators, and information for all stages of life,
from newborn to adulthood.
In addition, for more than 25 years, our Accredo
teams have been including “Accredo Cares
Packs” in treatment shipments to our pediatricpatients with bleeding disorders. The Accredo
Cares Packs started as a way to help easeanxiety for our pediatric patients who
have to get poked with needles as part oftheir treatment and include items like cartoon
character bandages, small toys, and books.

Accredo Earns URAC Rare Disease
Pharmacy Center of Excellence Designation
The URAC accreditation(19) recognizes Accredo, our specialty pharmacy,
for demonstrating commitment to quality health services, patient
safety, and improved outcomes for patients living with rare diseases.

18 HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). HEDIS is one of the most widely used performance improvement tools in health care and is a standardized
set of measurements for health plans that undergoes strict validation by NCQA auditors, who certify data reliability and integrity and evaluate the effectiveness of managed care clinical programs.
19 Founded in 1990 as a nonprofit organization, URAC is the independent leader in promoting health care quality and patient safety through renowned accreditation programs.
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Helping Customers Navigate Challenging Times
In response to Russia’s invasion of Ukraine in 2022,
many Western governments, including the United States,
sanctioned Russian banks, businesses, and individuals.
The necessity to fully comply with this complex matrixof legal obligations could have conflicted with our intent
of always putting customers first. We quickly mobilized
to understand the nuances of the various sanctions
and the range of customers potentially impacted.
We actively communicated with customers to ensure
they could navigate the implications of the situationand to minimize any impact on access to care.
For example, we implemented technology solutions
to avoid inadvertently paying claims into a sanctioned
bank, and we operationalized guidelines to ensure
our exposure was monitored and carefully controlled.

We also supported our customers through the many
natural disasters that struck in 2022. For example,
when Hurricane Ian hit Florida in late September,
we took a number of steps to help our customers
in the region access the care they needed as easily as
possible, including easing prescription requirements,
extending access to a toll-free help line, covering outof-network claims as in-network, and relaxing priorauthorization requirements.
See page 32 to learn more about our efforts in theface of disasters.

In Lee County, Florida, one of Hurricane Ian’s hardest hit areas, ourEvernorth Direct Health colleagues, in partnership with the Lee
County Sheriff’s Office, set up a mobile clinic for urgent care visits in
the hurricane’s aftermath. In just three days, the mobile unit was fully
functional as an urgent care walk-in clinic, and all Evernorth Directteam members were onsite to serve frontline workers and theirfamilies, refill medications, and provide telephonic visits. The teamsent out more than 1,500 messages to patients to inform them of themobile center’s temporary hours, services, and contact information.

WHERE WE’RE GOINGIN PRODUCT SERVICE
AND QUALITY
Looking ahead in Product Service
and Quality, we aim to maintainour URAC Rare Disease Centerof Excellence designation and ourSpecialty Pharmacy Accreditation.
We’ll also look to demonstrateprogress through our HEDIS
composite scores.

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Health Equity
Our health starts in the communities
where we are born, grow, work,
live, and age. That’s because SDOH,
or the wider set of forces and systems
shaping the conditions of daily life,
play an important role in achieving
optimal health and vitality.

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When social needs, such as food, transportation,communication, and cultural understanding andrespect, are not met, they can negatively impact
health status, utilization of care, and, ultimately,
health outcomes.
Many underrepresented segments of the
population, including racial and ethnic minorities,
individuals with disabilities, LGBTQ+ individuals, andpeople living in lower-income or rural communities,
are disproportionately impacted by negative social
conditions. This leads to health disparities, which aremeaningful and preventable differences in healthbetween members of the population. To achieve
health equity, or optimal health for all people,
we must address these complex societal andenvironmental drivers of care.

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Our Strategy
For more than 15 years, The Cigna Group has been on a
mission to ensure all people have the opportunity to achieve
their full health potential regardless of social, economic, or
environmental circumstances. We continue to lead industry
efforts, including active engagement with key stakeholders
and communities, to promote the identification of healthdisparities and initiatives to close gaps.
We take action to improve health equity through ourbusiness and our charitable giving efforts. Our Health
Equity Committee, part of our DEI Council (see page 41),drives oversight and accountability for our health equity
strategy, which is focused on what we refer to as the three
Es of equity:
1. Executing on health equity program goals
2. Eliminating health disparities in diabetes
3. Embedding health equity into all that we do

Expanding Access to Carefor LGBTQ+ Individuals
Over the last two years, we worked withmedical providers in our directory to assess
whether they feel competent and confident
in treating individuals who identify as
LGBTQ+. Now, LGBTQ+ individuals cansearch our provider directory for a physician
who aligns with their values. Looking
ahead, we are expanding this practiceto our dental provider directory.
Read more here about how healthequity for the LGBTQ+ community
starts with providers.

Please see page 30 for more information about
how we align our charitable giving efforts to SDOH.

How Data Helps Drive Health Equity
Our proprietary Social Determinants Index (SDI) helps us identify communities of customer populations
whose overall health status and utilization of care are negatively impacted by SDOH and where additional
resources may need to be deployed to reduce barriers to optimal health. Read more about the SDI here.

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Executing on Our Health
Equity Program Goals in 2022
In 2022, we met key milestones for each of thefollowing health equity programming goals, which
focus on innovation and solution enhancements,
provider collaboration, and digital equity:
1.1

Advanced programs to address theroot cause of health disparities

2.
2

Enhanced enterprise solutions to identify
disparity gaps

3.3

Influenced client planning to promotehealth equity

4.
4

Collaborated with providers as a partnerof choice

5.5

Progressed on commitment to expand
digital solutions

The following are some key initiatives that
helped us advance our goals in 2022.

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Maternal Health Pilot
Initially launched in 2021, our maternal health pilot aims
to reduce disparities in birth outcomes for Black mothersin the United States. Program elements include:• Implicit bias training for providers• Comprehensive risk screenings to identify thoseat risk for preterm birth• Free home delivery of prenatal vitamins and aspirin,
when prescribed for enrolled pregnant customers• Prenatal and postpartum screening for depression
and anxiety• Nurse advocates to connect with providers andpatients to remove barriers to a healthy pregnancy• SDOH screenings and referrals to local resources
for assistance as needed• Arranged transportation to/from OB-GYN prenatal
appointments as needed
Following early signs of success in 2021, we expanded
the program into three additional markets in 2022,
and we are adding many elements of the pilot into
our overall maternity program.

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Incentivizing Providers to Implement
Health Equity Actions
We include health equity performance measures as part of quality
metrics for some of our contracted collaborative accountablecare (CAC) providers.(20) We award these CAC provider groups
shared savings for efforts to improve quality and affordability,
including screening for SDOH and assessing health disparities
among their patient populations and developing action plansto address an identified disparity in their patient population. As
of June 2023, approximately 92% of our targeted CAC providers
have implemented SDOH screening for their patient population
and approximately 87% have identified a health disparity andare creating action plans to address those disparities.
In honor of the 15th anniversary of our CAC program, we
deepened our commitment to embedding health equity
outcomes into our value-based relationships by launching
the Health Equity Action Awards Challenge. The challengecelebrates and recognizes CAC provider partners who aregoing above and beyond to improve health equity in theircommunities. For example, our gold award winner, Novant
Health, conducted nearly 370,000 screenings for food insecurity,
provided emergency food packs, and connected nearly 60%
of food insecure patients with a local community resource.

MDLIVE Multicultural Campaign
In 2022, we expanded our maternal health pilot program into

three additional markets.

Through MDLIVE’s virtual care offering, we can leverage a broadand diverse provider network to expand access to care for many
individuals who face SDOH, such as transportation and copay
costs. To increase the use of MDLIVE for acute, episodic care incommunities with a high social need, we created a multicultural
marketing campaign directed to the diverse workforce of severalof our clients who may benefit from virtual care.

20 These measures are included for our CAC COVID Care and Total Medical Cost CAC provider groups.
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Eliminating Disparities in Diabetes
Diabetes is one of the most complex and costly chronic
conditions, and it disproportionately affects certain
populations, with SDOH contributing to the prevalenceof diabetes, timeliness of diagnosis, and quality andmaintenance of treatment. We aim to eliminate
health disparities in the incidence, management,
and progression of diabetes. In 2022, we took thefollowing steps toward meeting this goal.

Tech-Empowered Community
Health Worker Pilot
In late 2022, we launched a new pilot program to better
identify, engage, and empower customers living withdiabetes in communities at higher risk for health disparities.
This virtual program leverages community health workers
to engage, identify, and address participants’ SDOH andconnect them to relevant resources to meet their needs.
Condition knowledge, healthy eating, scheduling, andtransportation to appointments are some common barriers
being addressed through the pilot.

Focused Training for Hispanic/Latino
Diabetes Management
In partnership with our Juntos Enterprise Resource
Group (ERG) (see page 43), we evolved our caremanagement program by developing new training
resources for our customer-facing clinical employees
when working with Hispanic/Latino customers livingwith diabetes. More than 1,200 employees took thistraining, and 70% of them reported improved confidence
after course completion. This training is the third
installment in a series of multicultural training resources
for our customer-facing clinical employees. The first two
installments focus on better understanding customersof South Asian descent living with cardiovascular disease
and Black customers living with diabetes.

iTournament Challenge
Every year, our Aspire ERG (see page 43) holds a“Shark Tank”–style challenge to identify potential new
solutions to some of the most pressing health issues
that impact our business and the people we serve.
In 2022, the ERG partnered with the Health Equity
Committee of our DEI Council to focus on disparities
in diabetes. The challenge generated nearly 100 creative
submissions, and six finalists were chosen to present theirprojects to a panel of company leaders for considerationin our strategy planning. Ideas ranged from technology
advancements to community partnerships, and finalist
projects are being considered for pilots and other ways tooperationalize. The iTournament Challenge is one exampleof how we embed health equity into our culture to drive
innovation and make health equity a part of our DNA.

Diabetes Support through Individual and Family Plans(21)We offer select diabetes supplies at low or no cost as part of our eligible Individual and Family Plans, as well as
enhanced diabetes benefits as part of condition-specific plans, available in select markets. We’re proud that ourhealth plans help enable entrepreneurs. For example, an Indiana customer and her family were able to become
restaurant owners without worrying whether monthly diabetes medications would be affordable.

21 Different from employer-sponsored plans, our Individual and Family Plans (IFPs) business offers both individual medical and dental plans.
IFPs primarily serves people who purchase health insurance plans through the Individual Exchange, which was created as part of the Affordable Care Act in 2014.

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Embedding Health Equity
in All We Do
To further advance our health equity program, we areembedding health equity into our culture, systems, policies,
and practices. We empower our employees to approach
their work through an equity lens in multiple ways.

Digital Accessibility Policy and Program
In 2022, we created a Digital Accessibility Policy,
which outlines our commitment to ensuring that our
websites, our mobile applications, and all digital content
are accessible to individuals of all abilities. Further,
we formed a Digital Accessibility Steering Committee
in partnership with our ABLE ERG (see page 43).
The committee is made up of leaders from across theenterprise, and their mission is to strengthen the cultureof inclusivity, to eliminate digital accessibility barriers, andto empower all employees to achieve their full potential
within The Cigna Group.

Applying a Health Equity Lens
to Coverage Policy
Recognizing that risk factors for diseases and responses
to therapies can vary by race and ethnicity, our Coverage
Policy Unit reviewed all existing medical coverage policies
to ensure that the policies account for those differences
and recommended changes where needed. For example,
a recent review revealed that our policies did not accountfor findings that people of South Asian descent often
develop diabetes and cardiovascular disease at a much

Looking ahead, we plan to gauge ourprogress in embedding health equity
throughout our enterprise and how
frequently health equity–related services
are being used by our customers throughthe following:

lower body mass index (BMI) than their counterpartsof other racial and ethnic groups. Following the review,
we reduced the BMI required for bariatric surgery forpeople of Asian descent as a means to prevent or treat
diabetes and/or cardiovascular disease in this population.
Read another example here. The unit is also applying thishealth equity lens as new policies are developed.

• Direct customer race/ethnicity
demographic data collected• Types of collaborations with nonprofit
and for-profit organizations to drive
health equity initiatives with a focus
on SDOH

Employees as Health Equity
Advocates and Ambassadors
We empower employees to identify and implement
opportunities related to health equity throughstructured learning pathways and on-demand education
available through our learning management system.
In 2022, we established a Health Equity Communityof Practice—an opportunity for any employee, regardlessof role, to participate in monthly conversations about
health equity and how it may apply to their work.

Cross Cultural Diversity ForumThe Cross Cultural Diversity Forum is a dedicated groupwithin our Care Solutions business that aims to minimize
disparities in the delivery of clinical services to our diverse
customers. The group meets every six weeks to learn fromcolleagues’ clinical expertise, develop materials to educate
staff, and collaborate with others throughout the enterprise.

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WHERE
WE’RE GOING
IN HEALTHEQUITY• Number of employees completing
cultural competency and healthequity training• Number of translation requests fulfilledin support of inclusivity of our customers
with limited English proficiency• Number of requests fulfilled for healthliteracy and accessibility in support ofinclusivity for our deaf, hard of hearing,vision impaired, and blind customers
In 2023, we’re evolving our healthequity strategy and continuing to
identify opportunities to demonstrateprogress in advancing our health equity
goals and metrics.

Plus, see page 63 to read how we’re responsibly approaching
the use of augmented intelligence in our work.
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Community
Resilience
In 2022, our charitable
contributions totaled nearly$54 million. These donations
reflect and magnify the positive
impacts of our mission to
improve the health and vitalityof those we serve. The Cigna
Group gives to communities
in three primary ways: through
The Cigna Group Foundation(Foundation), corporate giving,and employee giving andvolunteerism.

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The Cigna Group Foundation
For more than 50 years, the Foundation has advanced
the company’s mission through charitable grants
to nonprofit organizations that create innovative
health solutions and address community needs
in ways that are sustainable, scalable, and effective.
The Foundation currently focuses giving on a few
primary areas, including health and well-being,education and workforce development, andcommunity and social issues. These focus areas arehighlighted through community impact programs,
such as Healthier Kids For Our Future, and throughthe Foundation’s support of our Building Equity andEquality Program.
Our charitable giving, with a focus on health equity
and access to health, helps to create more vibrant,
healthier, and more equitable communities. In 2022,
the Foundation funded 152 grants, 90% of which
supported efforts to address SDOH, as describedon the next page. Total Foundation giving in 2022
amounted to more than $16.5 million.

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2022 The Cigna Group Foundation Grants and How They Aligned to SDOH
90% of our 2022 Foundation grants supported efforts to address SDOH.

Other grants (10%)
Providing disaster
relief and employee
engagement donations

80

Health Care Accessgrants (53%)
Connecting community
members to clinicaland behavioral services
using community healthworkers and culturally
appropriate clinical staff

152
grants total

28

Economic Stability
grants (18%)
Connecting community
members to financial
resources to work
toward eliminating
food insecurity,
unemployment, andhousing instability

15

3Neighborhood andEnvironment grants (2%)
Supporting racial/ethnic minorities
and people with low incomes livingin places with risk of crime, noise,
inaccessible areas, and pollutants
that trigger asthma attacks

4

22

Education grants (14%)
Supporting access to early childhood
education, graduation from high school,
and affordable higher education

Social and Community grants (3%)
Supporting positive relationships
at home, at work, and in thecommunity, which can help
reduce negative health impacts

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Supporting the Building Equity
and Equality Program
The Building Equity and Equality Program, launchedin 2020, is a five-year initiative by The Cigna Groupto expand and accelerate efforts to support diversity,
inclusion, equity, and equality for communities of color.
The Foundation has provided support for this initiative
through grants to organizations that address SDOH and
improve access to education and job opportunities forunderserved and underrepresented groups.
For example, in 2022, the Foundation provided a grant
to a long-standing partner, the University of Maryland’s
Health Advocates In-Reach and Research (HAIR) program,to further amplify important health topics in the Black
community. Launched with the help of the Foundation,
HAIR builds upon the rich and powerful history of barbers
and beauticians as trusted entrepreneurs in Black andAfrican American communities, working with them toreduce disparities and create a local infrastructure of
public health and medical services, including healthscreenings and education. In 2022, HAIR developed aseries of comic books featuring local settings and healthfacts woven throughout the stories to educate readers
about important health topics. To boost the impact of
HAIR, The Cigna Group, the National Football League(NFL), and the Baltimore Ravens filmed a 30-second spot
featuring the program, which was televised nationallyduring NFL games on October 2.

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Healthier Kids For Our Future

Foundation and Employee Giving

Launched in 2019, Healthier Kids For Our Future is our
five-year, $25 million global initiative focused on improving
the health and well-being of children. In 2022, we entered
our fourth year of the program and awarded nearly$5.5 million in financial support to innovative programs
spanning communities in 19 states. See some programs
we partnered with here.

In addition to providing direct grants to nonprofits,
the Foundation also supports employees and employeedriven giving through direct grants to employee-selected
nonprofits and our matching gift program. Employees
donated more than $3 million to causes of their choicein 2022, of which approximately $2.7 million was matchedby the Foundation.

In honor of World Children’s Day (November 20),
the Foundation also gave 14 schools in the United Stateseach a $5,000 unrestricted gift to use as they see fit
to best support the students in their communities.

The Foundation also continued its support of The Cigna
Group Scholars Program in 2022, providing $3,000 highereducation scholarships to more than 270 dependents andgrandchildren of company employees. This program helps
to close the affordability gap for employees, their families,
and the next generation of students.

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Brave of Heart Fund Recognition
In 2020, the Foundation, along with the New YorkLife Foundation, initiated the Brave of Heart Fundto support the families of health care workers
and first responders who lost their life in thefight against COVID-19. Along with partner
E4E Relief, The Cigna Group and New York Life
Insurance Company received a 2022 Gold Haloaward from Engage for Good for this importantsafety net for those in need.(22)

Other Foundation 2022 Highlights
Funded Community Health Development Inc. in Uvalde, Texas,
to provide training, in partnership with the Center for Mind-Body
Medicine, to 250 first responders, teachers, and other community
members in mental health and trauma-healing skills to create a
network of mentorship and support. While the program benefits
the entire community, it focuses on individuals impacted by the
Robb Elementary School tragedy.

Supported American Indian students pursuing nursing degrees
by providing culturally competent academic advising, financial
assistance, tutoring, and community study sessions in partnershipwith the Montana State University Foundation. The program aims
to increase the enrollment and retention of American Indian
nursing students to build a strong pipeline of nurses to serve
communities, particularly in Tribal or American Indian HealthService facilities.

22 The application period for grants from the Brave of Heart Fund officially closed in 2021.
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Support in the
Wake of Disasters
Following the tragic school shooting in Uvalde,
Texas, and with similar heartbreaking eventsin New York and California only days apart, theFoundation made a donation to the National Allianceon Mental Illness (NAMI) to help support mental
health assistance and efforts (see also page 17).
Our employees also gave their time and talent
to support communities impacted by bothman-made and natural disasters and societal
challenges in 2022. Here are two examples:• European employees, working with Ukrainian
aid organizations in Brussels, organized support
for Ukrainian refugees arriving in Belgium.
The group helped pack hundreds of support
bags containing hygiene products and baby
and child care products for the refugees.
• In response to Hurricane Ian, hundredsof employees gave generously, and their
donations were matched by the Foundation,
which totaled approximately $75,000.
The Cigna Group Foundation committed
another $75,000 to the American
Red Cross to support hurricane
relief efforts.

Corporate Giving
In 2022, corporate giving from The Cigna Group included
sponsorships, donations, and contributions to nonprofits.
Our giving focused on increasing resources and services
that nonprofits can offer to community members
experiencing SDOH, such as food insecurity.

Employee Giving
In 2022, our U.S.-based employees logged approximately
57,000 hours for more than 700 causes in our company
volunteer portal, or approximately $2.8 million(23) involunteer-engagement value. We recognize employees
who volunteer and log 50+ hours with an eligible nonprofit
with a Community Service Champion award, which isa $500 grant from the Foundation sent directly to thenonprofit. We also invite all Community Service Champions
to apply to be recognized as Volunteer of the Year, earning
their nonprofit a $5,000 grant from the Foundation, as well
as a $2,500 personal award.

23 While hours volunteered remained largely consistent with 2021, the increase in dollar value is attributable to new information in regards to the dollar value of mentoring, pro-bono, and skills-based volunteering. Our Benevity
system now asks employees to distinguish the type of volunteering completed (historically, it did not). Mentoring, pro-bono, and skills-based volunteering have a much higher dollar value than traditional volunteering.

The Cigna Group Wellness in Motion (formerly
known as the Health Improvement Tour)
mobile clinic makes stops in communities
across the United States to offer free biometrichealth and skin cancer screenings, among
other health services. In 2022, the mobile
clinic engaged approximately 10,000 people,
screened approximately 1,500 people,
and hosted 48 events in 36 markets.

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In addition, to further empower employee philanthropy
and volunteering, we offer two distinct benefit programs:• The first is volunteer time off, referred to as "Use Your 8,"
for eligible employees to take eight hours of paid leaveannually to volunteer with a nonprofit of their choice.
• The second is our Community Ambassador Fellowship, a
program through which employees apply for up to threemonths of paid leave to support a specific communitybased project. Selected employees also receive up
to $20,000 in support of the project through a directcontribution to their nonprofit partner. Launched in2017, 47 employees have been a part of this powerfulexperience to date, and the collective impact of thisprogram reflects approximately 20,000 hours involunteerism and significant investment from The Cigna
Group to support program development and execution.

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2022 Community Ambassador Fellows
Kristal Ruiz partnered with Mind Blank to equip employers
and employees in Brisbane, Australia, with skills to identify
mental health issues. She helped create videos, conduct
market research, develop training manuals and crisis cards,
and hold pilot workshops in local workplaces customized toaddress specific industries’ struggles.
Joan Gitau partnered with the Heels4Pads Foundation toprovide young girls in Nairobi, Kenya, with necessities suchas sanitary towels to save them from sexual exploitation.
She worked with a local school to purchase, install, and filla sanitary napkin dispenser in the school that works like an
ATM. The project also provided the young girls with supplies,
tools, and instructions to make reusable napkins, and she
worked with their parents and caregivers to sew reusable
napkins for the girls to use when they aren’t at school.

Employees participated in many
volunteer activities around theDecember holidays. In Texas, employees
shared handmade caps for infants in the
neonatal intensive care unit at Texoma
Medical Center. The caps were deliveredon World Prematurity Day to help lift
spirits and share a message of support.

Shu-Ju Yang partnered with the Chinese American
Coalition for Compassionate Care (CACCC) to bridge
easier and earlier end-of-life conversations with Chinese
Americans. Shu-Ju used her knowledge and leveraged her
project-management skills to support CACCC’s Heart toHeart® Café, which offers compassionate communication
sessions designed to make it easier for a family member,a caregiver, or a health care provider to understand andhonor a loved one’s last wishes.
For more examples of our Community Ambassador
Fellows’ work, see this story.

WHERE WE’RE GOING INCOMMUNITY RESILIENCE
As we look forward, we are further refining
our charitable giving strategy and focus
areas to ensure outcomes in our local
communities. The Cigna Group willcontinue its efforts to narrow the gap on
health equity and impact SDOH while
enabling our employees around the world
to give their time and talent.

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HealthyWorkforce
We believe that employers play a vital rolein the health care system, and we strive to be a model forothers by prioritizing the health and vitality of employees
within our own company. A healthy and diverse workforce
is essential to achieving our mission, and we continuallyinvest in our employees to support their health and vitality,
to foster their growth and development, and to further
cultivate diversity and inclusion.

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Health and Vitality

Employee
Health, Safety,
and Vitality

Vitality is the capacity to pursue life with health, strength,and energy. Higher vitality is linked to better mental andphysical health, to higher levels of job satisfaction andperformance, and to a more motivated, connected, andproductive workforce. By better understanding vitality
and the factors that impact it, we can more deeply
understand the unique needs of our workforce, act
on that knowledge to inform meaningful investment
decisions, and grow. Helping people thrive is a competitive
point of differentiation for our business, and one that weinvest heavily in.
There are eight dimensions of vitality: physical, emotional,
occupational, spiritual, intellectual, environmental, financial,and social. A person’s ability to make their own choices
and be in control of their life across those dimensions—known as one’s autonomy, competency, and relatedness—
impacts their vitality. Our employee well-being strategy
and benefits programs (plus our DEI and learning anddevelopment efforts; see pages 40 and 46, respectively)
are designed to provide holistic support for these areas foreach of our 70,000+ employees worldwide and their families.

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Following is a sampling of our programs:• Emotional Health Resources – In 2022, we doubled
the number of employee assistance program (EAP)
visits that U.S. employees and members of theirhousehold can participate in: it is now up to 10 free,
confidential counseling sessions per year. In addition
to the traditional EAP, we’re introducing Confide
Behavioral Health NavigatorSM, a more personalized EAPexperience that offers, for example, a licensed clinician
navigator working with individuals along each step of
their journey. Confide is available to all U.S. employees
and their family members regardless of whether they
participate in our medical benefits. In the U.K., welaunched the 5% Pledge, encouraging business leaders tocommit 5% of working hours to supporting mental healthin the workplace.

• Condition Management Programs – Many of ouremployees are our own customers and benefit fromthe progress we are making with respect to sustainable
health care, product service and quality, and healthequity. For example, we, through our Cigna Healthcare
medical plan offering to employees, participated in the
Tech-Empowered Community Health Worker pilot in
2022 (see page 27), where we matched employees whoare enrolled in a Cigna Healthcare medical plan andliving with diabetes to trained individuals with shared
health conditions. Other programs, like our collaboration
with Omada, seek to help employees manage weight,
hypertension, and diabetes by providing dedicated healthcoaches who work with employees on individual healthand wellness goals.

Caregiver Leave
Effective as of January 1, 2023, we expanded our
caregiver leave program, doubling available leavefrom four to eight weeks. Our caregiver leave
program provides paid leave to enable employees
to bond with a child; care for a family member
with a serious health condition, which can include
care for children, spouses, parents, grandparents,
and grandchildren; care for a covered military
service member with a serious injury or illness;or care for qualifying exigencies.

• Support for Parents – Cigna Families is a program tohelp new parents welcome a child into their family via
birth or adoption by providing a gift such as an infant
car seat, toddler play set, or, for adopted teens, a wirelessheadphone/speaker set. We also offer lactation consulting
and support for new moms. In 2022, we continued apilot program to offer subsidized emergency childcare at
KinderCare centers for a targeted employee population.
• Financial Well-Being – We offer our employees debt
and credit counseling, student loan debt consolidation
support, low-interest loans that can be repaid via payroll
deduction, and one-on-one retirement counseling, inaddition to a competitive 401(k) match. We’re proudthat approximately 90% of our U.S.-based employees
participate in our 401(k) and that nearly 65% take fulladvantage of our company match, as of the end of2022. In addition to these company-provided solutions,
The Cigna Group offers voluntary benefits and discountprograms that employees may choose to participate in
to further support their well-being.
• Paid Time Off – Depending on career level andgeographic location, we offer a minimum 12 to 28
days of paid time off (PTO) per year to our employees.
We also have dedicated paid sick time as part of our
PTO allotment for all our employees.

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H E A LT H Y S O C I E T Y• Global Wellness Challenge – Our annual six-weekwellness campaign encourages all global employees,
spouses, and dependents over the age of 13 to strengthen
their whole-person health through physical activities,
mindfulness, and social connections. In 2022, more than
23,000 participants logged more than 60 million minutesof activity.
• Fitness and Nutrition Resources – In 2022, weannounced a new partnership with Peloton for the
benefit of our employees. Our U.S. employees now havefree access to the Peloton App, which offers thousandsof live and on-demand classes, including cardio, strength,yoga, and meditation, with no equipment needed.
In connection with the launch of this new program,
The Cigna Group gave away several Peloton Bikes
and Treads. Within three months of launch, 30%
of our U.S. population had enrolled in the program.
Our international employees have access to the wellness
app Wellbeats. We also offer nutrition resources, such as
Foodsmart, to U.S. employees to help guide themto healthy food choices and preparation.

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In 2022, The Cigna Group invested approximately 18% of total payroll in health,well-being, and other benefits, including life and disability programs, 401(k)contributions, and retirement-related benefits for employees in the United States.
We continually work to build and reinforce a culture of health and vitality within
our company and include questions on our annual employee engagement survey
to assess how we are doing.
In 2022, with an 83% employee response rate,(24) results showed:

88% of employees believe
their manager actively
supports employee
health and well-being

76% of employees believe
their job isn’t a barrier totheir personal health and/or
the health of their family

83% of employees know how
to engage in the programs,
resources, and tools provided
by The Cigna Group to improveor maintain their health

24 Our annual employee engagement survey is distributed globally but regional markets may choose to opt out of participation. This figure represents the results of those that participated.
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Occupational Health and Safety
Our Occupational Health and Safety Policy outlines theelements of our comprehensive occupational healthand safety framework, including governance, worker
participation, hazard identification and assessment,
education and training, and continuous improvement.
It leverages principles from the International Organizationfor Standardization (ISO) ISO 45001, and in 2023, we
will conduct third-party pre-ISO certification audits at
our high-volume fulfillment centers, which are ourhighest-risk locations from an occupational safety
perspective. The policy applies to all of our facilities andemployees in the United States and calls for coordination
with contractors to provide them with the same level ofhealth and safety protection. Our facilities in international
markets and contractors are required to comply with local
regulations for worker safety and health.

In 2023, we will conduct
third-party pre-ISO
certification audits
at our high-volume
fulfillment centers

Oversight and Risk Management

Employee Education and Training

Our Global Risk Management and Safety teams, withexecutive oversight from our Chief Financial Officer, leadour occupational health and safety processes across theenterprise. The teams regularly collaborate with internaland external stakeholders on safety topics. For example,
the Safety team hosted a Safety Summit in 2022 toengage with key business partners on safety-related
business strategies and priorities, as well as to educate
and train them.

All employees are required to complete our Safety
in the Workplace training, which covers basic safety andcompliance topics and which is reviewed and refreshedannually. Additional safety training is required of certain
employee groups based on job function and thetype of work performed by those groups.

In addition to the Global Risk Management and
Safety teams, our Safety Committees are responsible
for monitoring, communicating, and participating in
occupational health and safety matters. This includes
identifying hazards through safety observations andinspections, helping to prevent injury and illness,
supporting emergency preparedness efforts, and raisingawareness on safety topics among our employees. Safety
Committees include joint management and worker teammembers with cross-functional representation.
We regularly conduct risk assessments to review specificprojects, process changes, machinery and equipment, andother safety-related initiatives to gauge the level of injury
and illness risk to our employees and ensure compliance.

Health and safety information is constantly disseminatedto our employees through toolbox talks, postings onbulletin boards, digital monitors and awareness campaigns.
For example, the Safety Committee at our Florence,
New Jersey, fulfillment center implemented “Safety Saves,”
a simple process to encourage employees to suggest
health and safety improvements at their workplace.
Since the program’s inception two years ago, dozens
of suggestions have been received and addressed.

In the last two years,"Safety Saves"

has received and addressed
dozens of suggestions.

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Preventing Ergonomic Challenges
With many of our employees working at desks,
ergonomics is incredibly important to their healthand safety. We provide our employees with a numberof ergonomics-related tools and resources, including:• An office workstation ergonomics training course
through myUniversity• An online office ergonomics assessment andtraining that allows employees to self-assess
and resolve their issues• Ergonomic essentials for the office environment
and non-office or production environment in therequired Safety in the Workplace training• Information on our intranet, including how toadjust your workstation, stretching, checklists,
infographics, and additional training materials
on ergonomics• Vocational counselors to assist employees withproper workstation setup and musculoskeletal
pain and discomfort

We regularly implement ergonomic improvements
throughout the company, in both office and non-officeor production environments. For example, in 2022,
we installed a vacuum lift system for ice boxes used
for shipping pharmaceuticals at our St. Louis, Missouri,
fulfillment center, resulting in zero injuries from lifting
ice boxes since the system was operational. At ourWhitestown, Indiana, fulfillment center, we replaced
an auto-publish room printer that reduced the potential
for overexertion strain injuries. The previous process
required employees to pick up a heavy metal container
with paper trimmings and reach overhead to dump it
into a bulk bin. Plus, the new printer reduces the amountof paper used by enabling two-up vs. one-up printing.
Additional information about occupational healthand safety at The Cigna Group can be found in the
GRI Index, page 81.

WHERE WE’RE GOING IN EMPLOYEE HEALTH, SAFETY, AND VITALITY
To further demonstrate progress as it relates to our employees’ health, safety, andvitality, we plan to measure our employees’ utilization of physical health programs
and mental and financial health benefits. We also plan to disclose more information
about our occupational health and safety risk assessments and related metrics.

As some facilities underwent renovationsin 2022, we gave away ergonomic officechairs that were not regularly being used
to our employees. For example, while ourWarrendale, Pennsylvania, facility was
under construction, we held a lottery andgave away 43 chairs that were no longer
needed (pictured above is lottery winnerand employee Michelle Pergal).
Not only does this promote healthand safety but it repurposes chairsthat may otherwise end
up in landfills.

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Diversity,
Equity, andInclusion(DEI) within
Our Workforce
We recognize that ourcontinued success depends
on the collective strengthsof our employees.

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At The Cigna Group, our individual differences—including race, ethnicity, nationality, military or veteranstatus, disability, age, religion, sexual orientation, andgender identity or expression—represent a mosaic ofbackgrounds, experiences, and perspectives that enable
us to deliver on our mission and to innovate and create
solutions that resonate with our customers, partners,
and communities.
We are committed to fostering a culture of belonging
and equity among our diverse workforce that advances
our ability to improve the health and vitality of those
we serve. This is demonstrated through our DEI strategy;
through our programs and practices to attract, retain,
and reward our employees; and through the actionsof our enterprise DEI Council.

Our DEI strategy focuses on:• Elevating the next set of diverse leaders• Striving to ensure every employee feels a sense of
belonging and is able to reach their fullest potential• Proactively monitoring our people processes andprograms to promote equitable outcomes• Driving the impact of DEI with our colleagues,
customers, clients, and communities

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Our DEI Council is chaired by our Chairman and CEO
and is composed of leaders from various areas of thecompany. The DEI Council includes two committees
that focus on advancing health equity (see page 24)
and continuing to strengthen our leadership accountability.
In 2022, Dr. Luis Torres, a member of our DEI Council and
Health Equity Committee, was assigned as our second
fellow to the CEO Action for Racial Equity.

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Another way in which we measure our progress relative
to our DEI commitments is through the responses to acollection of relevant questions on our annual employee
engagement survey that we refer to as the DEI index.
In 2022, with an 83% employee response
rate,(25) responses to these questions showed:

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To hold our leaders accountable to our DEI commitments,
our DEI index performance and our progress relative
to our aspirational representation goals are componentsof the measures that determine the funding of
our Enterprise Incentive Plan(26) pursuant to which
employee bonuses are paid.

86% of employees believe
their manager encourages
diversity and inclusion

At the end of 2022,

71%

of our global employees
self-identified as women, andDiversity Scorecard
As a tangible example of our commitment to
DEI leadership and transparency, we publish
an annual DEI Scorecard. Please visit the
DEI Scorecard for details on 2022 actions andprogress among our culture and coworkers,
clients and customers, and communities.

In 2020, we set an aspirational goal to improve genderequality in our leadership pipeline by increasing thenumber of women in our director and senior directorroles from 45 to 50% by the end of 2024. As of theend of 2022, we have nearly 48% women in director
and senior director level roles.

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80% of employees believe
they can freely express
opinions/views without fearof negative consequences

85% of employees believe
The Cigna Group values andpromotes employee diversity

39%
Representation
at The CignaGroupof our employees in the
United States self-identified
as ethnic minorities (which
includes Black/African
American, Asian, Hispanic
or Latino, Pacific Islander,
American Indian/Alaskan,
and two or more races).
Additional information on thediversity of our workforce canbe found on page 69.

25 Our annual employee engagement survey is distributed globally but regional markets may choose
to opt out of participation. This figure represents the results of those that participated.
26 See our 2023 Proxy Statement for more information.
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Ensuring Equity in Our Talent Strategy
DEI and workforce mobility are at the foundation of ourculture at The Cigna Group, and we are proud of the actions
we’ve taken to address racial equity and advance opportunity
and mobility for all of our employees. At The Cigna Group,
these efforts start at the earliest stages of recruiting andworkforce development.
We leverage our Enterprise Resource Groups (ERGs) in
our talent attraction efforts, partner with Historically Black
Colleges and Universities (HBCUs) and Minority Serving
Institutions (MSIs), and work with many diverse recruitingorganizations. In 2022, we achieved 90% diverse slates forexternal requisitions of manager-level and above roles, whichyielded 64% diverse hires (women, ethnic minorities, or both).
We have training, processes, and procedures in place to help
ensure all decisions related to recruiting, hiring, promoting,and all other personnel actions are made without regard
to an individual’s race, color, religion, ethnicity, gender,or sexual orientation. For example, we require all newhires to take unconscious bias training to help ensurethat recruiting, hiring, promoting, and other personnel
decisions are focused solely on skills and qualifications.
In 2022, we invited employees to voluntarily andconfidentially self-disclose certain personal indicators,
such as sexual orientation, gender identity, and disability,
within our Workday platform. Understanding the diversityof our workforce allows us to make more informed,
inclusive, and equitable decisions about benefits, training
and development, and other programs that we may offer.

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Leadership Development

Fair Pay

Another way we ensure equity in our talent strategy is throughleadership development. For example, our partnershipwith organizations such as McKinsey’s Connected Leaders
Academy, Tenshey, and Blue Circle Leadership aims toadvance racial and gender equity by investing in future
leaders of diverse backgrounds. The Cigna Group works withthese partners on a range of programming for career growth,
including the development of high-performing early- to midcareer managers and executive coaching.

We are committed to fairness in pay and opportunity for
all of our employees. Our compensation practices, rooted in
our pay-for-performance philosophy, promote equity in pay
through measures such as benchmarking compensation
by role, eliminating questions on applicants’ compensation
history, and monitoring for potential disparities.

Another example is the Women Leaders Program in
our International Health team. For each of the past three
years, 50 women leaders have participated to enhancecompetencies that promote effective leadership behavior.
Please see this story and page 46 for additional leadershipdevelopment programs available to our employees.

Our most recent pay equity analysis among our
U.S. employees, conducted in 2023, showed that female
employees at The Cigna Group earn more than 99 centsfor every dollar earned by similarly situated male
employees, and employees from underrepresented
groups earn more than 99 cents for every dollar earnedby similarly situated white employees. In 2022, for the firsttime, we also analyzed gender pay on a global basis andfound that across the entire company, female employees
at The Cigna Group earn more than 99 cents for every
dollar earned by similarly situated male employees.

Supporting Our Transgender Colleagues
As a global health company, we understand the need for comprehensive benefits and resources to support
transgender employees’ gender-affirming care, including for individuals going through transition. In 2022,
we created an employee-facing guide that provides tools and resources to help employees navigate gendertransition. We also created a manager-facing guide to further support a transgender colleague’s transition. And
we launched a dedicated customer support line for our transgender customers, which includes our employees.
In addition to these new resources, The Cigna Group also announced that we expanded our health plan’s travel
benefit to include travel for gender-affirming care for The Cigna Group employees and their dependents whoare enrolled in a Cigna Healthcare medical plan and who live in regions where access is restricted.

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ESG PERFORMANCE METRICSEnterprise Resource Groups (ERGs)
Championing a diverse and inclusive workplace improves
our ability to innovate and create solutions that resonate
with our colleagues, customers, and communities. One of
the ways we bring DEI to life is through our 11 ERGs andLean-In Circles. ERGs are employee-led and employeegoverned organizations sponsored by the executives of The
Cigna Group. Each ERG has a unique focus, fostering crosscompany connections among employees whose paths
might never cross during the course of a regular workday.
They offer employees the opportunity to network, enhance
personal development, contribute to a diverse and inclusive
work environment, and give back to the community
through partnerships with leading organizations.

In 2022, our ERGs sponsored many events and activities.
Following is a sampling:• ABLE: Hosted both Lou Ferrigno, known for portraying
the Incredible Hulk, to learn about his professional andpersonal journey overcoming the challenges of hearing
impairment and LinkedIn Leader Jennison Asuncion, whoshared his experience as a blind professional in technology.
• Aspire: Held annual iTournament “Shark Tank” competition
with health equity focus. See page 27 for more details.

11 ERGs, ~13,000 members

African American/
Black
Aspire(Asian/South Asian)Generations(Multigenerational)

Juntos(Hispanic/Latino)

UpNext(Career Mobility)

Pride(LGBTQ+)

VirtualSalute(Veterans/Military)
UpLift(Interfaith)• Juntos: Raised money to support the Uvalde Strong
Fund, helping families affected by the Uvalde school
shooting as well as nonprofit and medical partners within
the Uvalde community. Read how we supportand empower the Hispanic community here.
• Salute: Hosted at-home and onsite volunteer
opportunities with Operation Gratitude. Read how
we support the veteran community, active military
members, and their families here.
• WIN, Virtual, and Lean-In Circles: Collaborated to holdthe second annual Global Women’s Leadership Summit
as part of our commitment to advance women’s equity
and equality.

(27)

ABLE
(Achieving Better
Lives for Everyone)• Generations: Celebrated National Family Caregivers
Month with a theme of “Self-Care Isn’t Selfish,” andhighlighted tips to improve overall health and well-being.

WIN(Women Influencing
and Networking)

WHERE WE’RE GOING IN DEI WITHIN OUR WORKFORCE
We’re undergoing strategy work in 2023 to evolve our DEI focus areas.
Our goal is to continue to drive business integration, create sustainability
and shared ownership of DEI, and evolve to a culture not only focused on
inclusion but one of belonging across the enterprise. We believe this will
enable our collective vision of a better future built on the vitality of every
individual and every community.

27 This number represents unique members, or employees who are in at least one ERG. In our 2021 Corporate Responsibility Report,
we reported the aggregate number of employees in all ERGs, inclusive of whether the employee was in multiple ERGs.
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Talent Attraction and Retention

Human
CapitalDevelopment

Our talent acquisition and rewards strategies aredesigned to attract and retain skilled employees whoare engaged in our mission. Our talent acquisitionteam is on the ground and online at community events,
colleges and universities, professional conferences,and job fairs and is embedded within community
organizations to find and recruit the best and brightest
talent. We’ve also expanded our virtual presence
through the Handshake App, the largest early career
network, with more than 12 million students and alumni
across 90% of the top educational institutions in the
United States.
We also launched an internal career portal to bettersupport internal mobility. As of the end of 2022,
approximately 27,000 employees created profiles
within the tool and approximately 66% of open
positions (excluding entry-level roles) were filled
by internal candidates.

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We recognize the importance of flexibility in theworkplace and provide schedules, tools, and support
for employees to balance their work responsibilities
with their life outside of work. For example, we offer
a variety of schedules for our call center employees
outside of traditional work hours, and we have aplatform available on which they can submit schedulechanges. Our scheduling team partners with ourrecruiters in Talent Acquisition to provide schedules
for their recruitment conversations so that candidates
have good visibility into schedules before they start.

Boomeranging Backto The Cigna GroupA testament to our culture andworkplace is when former colleagues,
known as “boomerangs,” come backto work at The Cigna Group. Senior
Recruiter Laura Alexander originallyjoined The Cigna Group in 2016 and thenboomeranged back in 2022 after leaving
to pursue another opportunity. She says,“The Cigna Group is truly an amazing
place to work. The culture is fantastic,
and there are a lot of long-term growth
opportunities. With colleagues based all
throughout the world, The Cigna Group
does a great job of keeping employees’in the know’ and connected toeach other. I appreciate the clear
expectations, the support fromleadership, and the tools I’m given
to be successful in my role. I canconfidently say The Cigna Groupis the best company I’ve beena part of.”

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In 2022, ourboomerang
hires wereup 12%

year-over-year.

Employee Engagement
We regularly measure employee engagement
through global surveys, and our leaders use theresults to identify ways to strengthen our culture
and retention, simplify processes, enhance employee
satisfaction, support employee well-being, andimprove customer interactions.
In 2022, 83% responded to our annual employee
engagement survey.(28) Our employee Net Promoter
Score (NPS)—an indication of whether employees
would recommend someone else come work at The
Cigna Group—increased over 2021, putting us aheadof external benchmarks, and the survey demonstrated
increased excitement for the future from employees.

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Overall, 77% of employees responded
favorably to questions related toengagement. For example:

87% of employees feelthey have a supportive
network of colleagues

84% of employees said
they find meaning andpurpose in their work

28 Our annual employee engagement survey is distributed globally but regional markets may choose
to opt out of participation. This figure represents the results of those that participated.
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Training and Development
Based on employees’ survey responses, we arerenewing our focus on individual and team goal
setting and continuing to improve how our
70,000+ employees work together.
To further engage and reward employees, we have an
employee recognition program called Cigna Standout
that allows employees to recognize their colleagues
for their contributions to our company and tocelebrate both personal and professional milestones.
Everyone is empowered to use this system to recognize
colleagues for going above and beyond or simply say
thank you. Additionally, colleagues can nominate
Quarterly Standouts for exceptional, “best of the best”
contributions or performances that have a significant,positive impact on patients, customers, or coworkers.
Quarterly Standouts then have the opportunity to berecognized at our annual CEO celebration.

We aim to foster a learning culture within The Cigna
Group—advancing the efficiency, effectiveness, andadoption of learning across the enterprise and focusing
on learning as the foundation of our talent strategy
through building skills and advancing career development.
Our online learning platform, known as myUniversity,and career development tools and events offer a broad
range of training, education, and development resources
to all employees. In 2022, we expanded content on
myUniversity and introduced TED@Work, a new way
to experience learning, with content that is designed
to help our employees work smarter, better, and withpurpose (and often with videos shorter than 10 minutes).
We also offer an education reimbursement program forboth full- and part-time employees in the United States
who meet the continuing education criteria.

QuarterlyStandouts

have the opportunity
to be recognized at ourannual CEO celebration.

92%of the global employee
population are active
myUniversity users

34

average learning hours
per employee(29)Ongoing
Employee
Education
Performance

2.4M

approximate total
hours of learning67%

of employees have assessedat least one of their skills,
resulting in a 10% increasein skill assessments over 2021

68

average NPS of enterpriselearning programs

29 In previous years we calculated our average learning hours per employee by using the average hours reported in the annual Association for Talent Development State of the Industry report and adding the actual
hours of learning captured in our systems. In 2022, we updated our methodology to only include our internal data, which we feel is a more accurate depiction of learning activity across the enterprise.

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Leadership Development

Early Career Development

Enterprise leadership development programs areprovided to executive, high-potential, and new manager
audiences to develop and expand our leadership capability.
Following is a sampling of our leadership programs in 2022:

To attract and develop diverse talent, we offer leadershipdevelopment programs to recent graduates who seek
valuable career experience with The Cigna Group.
We also offer college students opportunities to join
The Cigna Group for a paid summer internship.
Visit our careers website for information about summer
internships, undergraduate rotational programs, andgraduate and MBA rotational programs.

• Leadership Academy: A virtual development
experience for top-performing leaders to explore
their impact as a leader and their ability to influenceothers, as well as enhance their critical thinking andproblem-solving skills through practical application.
• People Leader Forums: We continued People
Leader Forums with internal and external speakers
covering topics including leadership brand, imposter
syndrome, talent mobility, networking, and leadingwith purposeful presence.
• Accelerate Leadership Program: Top performers
within our pharmacy benefit management businesstake their leadership skills and knowledge to the nextlevel during this year-long program by discussing topics
including financial acumen, unconscious bias, adaptivechange, and situational leadership. Our first classof 41 colleagues graduated in 2022.
Also in 2022, we launched required leadership training
for all new managers. This training focuses on coreleadership competencies and includes a three-day virtual
course covering career development, characteristics
of a cohesive team, DEI, team advocacy, and quality
coaching, among other topics.

Enabling Performance Growthand Development
Rather than an annual performance review process,we emphasize continuous, quality check-in conversations
throughout the year with our Connect for Growth approach.
We expect these conversations to be meaningful dialogues
between managers and employees to discuss goals, set
expectations, review progress and contributions, and alignindividual career aspirations with organizational priorities.

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We also strongly encourage employees to set goals, toreview them with their manager, and to document them,as our analyses have shown that employees who document
their goals are more likely to have higher performance, an
improved sense of feeling valued, and greater satisfaction
with career development. In 2022, we introduced two
new questions related to goals in our annual employee
engagement survey. Employees responded favorably,
indicating that they have specific goals to measure successagainst, and 90% of employees said they review their goal
progress with their manager on a regular basis.
Our Connect for Growth resources include employee andmanager guides, reflection tools, self-directed learning,
and facilitated webinars. Managers and employees are also
encouraged to attend “Quick Chats,” informal, 30-minutediscussions that occur weekly throughout the year on goal
setting and other career and performance topics.

WHERE WE’RE GOING IN HUMAN CAPITAL DEVELOPMENT
Looking ahead in Human Capital Development, we are continuing to refine how wemeasure and report progress toward our goal of being an employer of choice and thereturn on investment on our programs, initiatives, and practices relative to talent attraction
and retention, employee engagement, and training and development.

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Healthy
Environment
We believe that responsible environmental stewardshipcan improve health and vitality—and also makes soundbusiness sense. We strive to identify new efficiencies
and make strategic investments that reduce ourenvironmental impacts and our operating costs. In
addition, we see an opportunity to positively impact
the environment through a number of ways weare advancing our business, including through ourcontinued investment in virtual care.

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Climate Change
and Emissions
As a global health company,
we are keenly focused on theconnection between planetary
health and human health.

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We recognize that climate change presents global
public health challenges, such as those relating to
extreme weather events, decreases in water supply,
heat exposure, and declining crop yields. We also
acknowledge that the effects of climate change
disproportionately impact communities that face socialand economic discrimination, contributing to further
health inequity.(30) We take a precautionary approachto our environmental sustainability efforts, which isoutlined in our Environmental Policy Statement.
Our direct environmental impacts, particularly our
Scope 1 and 2 greenhouse gas (GHG) emissions, stem
primarily from our global real estate portfolio, which
has a footprint of approximately 9.8 million square feetas of the end of 2022 (of which approximately 9 million
square feet are part of our Scope 1 and 2 emissions
initiatives). Our strategic sustainability performanceplan, which is reviewed and updated annually, supports
the environmental management of our global realestate portfolio and leverages ISO 14001 continuous
improvement principles.

30 U.S. Department of Health and Human Services (HHS). “Climate Change & Health Equity,and Environmental Justice at HHS.” Last reviewed March 30, 2023.
https://www.hhs.gov/climate-change-health-equity-environmental-justice/index.html

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Our GHG Footprint
Our Scope 1 and 2 operational GHG footprint is made up
of two primary activities: operating our buildings, which
comprises electricity, heating, and cooling; and operatingcompany-owned aircraft and vehicles for a small portionof our business travel. Scope 2 emissions from purchased
electricity are the largest drivers of our building-related
emissions and overall operational GHG footprint. In 2022,
our combined Scope 1 and 2 location-based GHG emissions
decreased by approximately 9% over 2021 and our marketbased GHG emissions decreased by approximately 31%;
however, our Scope 1 emissions increased by approximately
16%.(31) We attribute this to an increase in our fleet vehicle
usage as we saw a return to more regular travel comparedto pandemic levels. We reduced our market-based
Scope 2 GHG emissions by approximately 37% andour location-based Scope 2 emissions by approximately
12% over 2021. Since our 2019 baseline, we’ve reduced
our overall Scope 1 and 2 footprint by 44%,(31) making
significant progress toward achieving our goal of reducing
Scope 1 and 2 emissions (market-based) 50% by 2030.
We have begun evaluating our Scope 3 emissions beyond
business travel and determining the categories that are
most relevant to our business. In addition to businesstravel (category 6), we are working to disclose additional
categories in our 2023 CDP Climate Change response
31 Limited assurance of bold data points has been provided by ERM CVS. Please see the assurance statement page
97 for further details.
32 Business travel for The Cigna Group global operations includes hotel stays, rail mileage, and commercial air travel
mileage broken down by flight segments. All data is obtained through Carlson Wagonlit Travel, the company’s thirdparty booking system used across our global operations. We updated our 2022 Scope 3 business travel emissions
shortly after our original 2022 ESG Report publication on July 10, 2023. We adjusted the value to more accurately
and consistently apply the UK’s Department for Environment, Food & Rural Affairs (DEFRA) methodology.
33 Scientific studies include sources from the National Library of Medicine, npj Digital Medicine, UC Davis Health,and JAMA Network.
34 U.S. Environmental Protection Agency (EPA). “Greenhouse Gas Equivalencies Calculator.”
Last updated May 30, 2023. https://www.epa.gov/energy/greenhouse-gas-equivalencies-calculator

and future reports. As an outcome of our Scope 3 inventory
and accompanying analysis, we intend to set science-based
GHG reduction targets and receive validation from the
Science Based Targets Initiative (SBTi).
In 2022, Scope 3 emissions from business travel totaled
approximately 10,500 metric tons.(32) We aim to minimize
travel when possible by leveraging virtual technology.
Necessary business travel must be approved by seniorleadership. For those who need to travel between major
cities on the Eastern Seaboard, we encourage the useof rail transportation.
One of the ways we are working to reduce our footprint
is by focusing on how we deliver medications directly topatients’ homes, which is part of our pharmacy business.
Our custom carrier network includes strategic partnerships
with FedEx, UPS, DHL, and the U.S. Postal Service, all ofwhich leverage their national scale and fleet to optimize
delivery routes and minimize carbon emissions whenpossible. Within our Accredo pharmacy, we worked with
our machine learning team to go beyond group shippingand create a model that can look at different versions of
the same address and recognize, with high confidence,that they are the same address. In just a couple months,
the initiative saved hundreds of thousands in postage costs
and enhanced our shipping efficiency.
As mentioned in Sustainable Health Care (see page 19),
we are navigating patients to optimal sites of care, including
virtual, digital, and in-home alternatives. Multiple scientificstudies(33) illustrate that telemedicine and access to digital
health can reduce GHG emissions due to less patient
travel to and from clinics. We estimate that potentiallyapproximately 8,600 metric tons of GHG emissions were
avoided in 2022 as a result of patients using our MDLIVE
virtual care services versus driving to and from a clinic.
This is equivalent to removing nearly 2,000 gas-poweredcars off the road for one year.(34)44%

reduction of our Scope 1 and2 emissions compared to 2019baseline, making significant
progress toward our goal of
reducing Scope 1 and 2 emissions(market-based) 50% by 2030.

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How We Will Achieve
Carbon-Neutral Operations
We are committed to maintaining carbon-neutral
operations after we achieve our initial goal set for2040. Our commitment includes Scope 1 (direct)
GHG emissions from building operations andcompany-owned aircraft and vehicles, as wellas Scope 2 (indirect) GHG emissions frompurchased electricity.
Our strategy to achieve—and maintain—carbon-neutral
operations is focused on the following elements:• Improving efficiency: Our first priority is to reduce
the amount of energy we use. We have undertaken
a range of energy-efficiency measures across ouroperations, and we plan to implement additional
improvements over the next decade (see page 52).
• Sourcing renewables: We committed to sourcing
100% renewable electricity by 2030, joining the
global RE100 pledge in 2022. As of the end of 2022,
we have sourced 28% of our global power needsfrom renewable electricity. We also recently
conducted a solar feasibility study to identify onsite
solar opportunities at The Cigna Group properties,
especially at our most energy-intensive sites. Currently,
our Franklin Lakes, New Jersey, location has onsite solar
generation capabilities. And we continue to explore
executing long-term renewable energy procurementagreements, including power purchase agreements
and green power supply contracts.
35 The Cigna Group leases space in the colocation center in Piscataway, New Jersey, from QTS. QTS executeda 10-year power purchase agreement in 2019 and provides an annual attestation to The Cigna Group of theRECs for the electricity consumed. https://www.datacenterdynamics.com/en/news/qts-power-two-data-centers100-percent-renewable-energy-ppa

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Our Operational Sustainability Targets
We set the following targets to drive progress on operational sustainability:• Reduce Scope 1 and 2 GHG emissions by 50%
by 2030 from 2019 baseline (see page 50).
• Achieve carbon neutrality for Scope 1 and 2
GHG emissions by 2040 (see this page).
• Source renewable electricity for 100% of ourglobal power needs by 2030 (see this page).
• Reduce overall water consumption
per square foot by 30% at facilities
where The Cigna Group is the customerof contact on the utility invoice by 2030
from 2019 baseline (see page 53).

• Reduce water consumption
per square foot by 50% for high-risk
facilities where The Cigna Groupis the customer of contact on theutility invoice by 2030 from 2019baseline (see page 53).
• Achieve zero paper, plastic
and e-waste for all sites where
The Cigna Group is the customerof contact on the hauler invoiceby 2030 (see page 54).

• Purchasing Energy Attribute Certificates (EACs):
To address our remaining direct emissions, we arepurchasing applicable EACs, including Green-e® certified
Renewable Energy Certificates (RECs). In 2022, wepurchased RECs to address 100% of our electricity usageat five of our most energy intensive locations: our data
centers in Connecticut, Illinois, and Virginia; our largest
pharmacy distribution center; and our Bloomfield,
Connecticut, headquarters. Plus, 100% of the electricity
at our colocation data center in New Jersey comes fromrenewable sources of energy.(35)

WHERE WE’RE GOING IN
CLIMATE CHANGE AND EMISSIONSAs we continue our Scope 3 emissions
inventory, we will analyze the results
and aim to set science-basedtargets, including creating detailed
decarbonization road maps andseeking validation from SBTi.

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Sustainable Buildings
As part of our efforts to increase the sustainabilityof our buildings, we have implemented a numberof efficiency measures across our operations.

Sustainable
Operations

As of December 31, 2022:

To further support ouroperational sustainability
targets and reduce ourenvironmental impact,
we prioritize efficiency inour buildings, responsible
water management, andproper waste reduction.

• Both of our office locations in the U.K. held an ISO
50001 Energy Management System Accreditation• ~15% of managed and controlled sites were
LEED® certified• ~89% of our managed sites were tracked in the
U.S. EPA’s ENERGY STAR program

We also continued to prioritize leasing LEED-certified
buildings and implement various energy efficiency
measures across our locations. We completed lighting
upgrade projects at our Atlanta, Georgia; Orlando, Florida;
and St. Louis, Missouri, locations. For example, we refreshedour office in Clayton, Missouri, replacing all existing lights
with LEDs and updating the cooling system. These actions
are estimated to save nearly 60,000 kilowatt hours (kWh)of energy and $7,000 in energy costs per year.
The Cigna Group is also piloting a site energy scorecard
program, starting with our major distribution center in
Grove City, Ohio. The goal is to identify energy efficiency
opportunities and optimize our building operations using
automation platforms, such as WebCTRL.

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Responsible Water Management
We use a variety of strategies and technologies thatlessen the burden of our operations on the potablewater supply and wastewater systems. We are guided
by the following model:• Monitor water consumption performance.
• Maximize fixture-related potable water efficiency
within buildings with the use of low-flow plumbing
fixtures, sensors, and automatic controls.
• Practice water-efficient landscaping and smartefficiency irrigation technology.
• Protect natural habitats, waterways, and water supplies
from pollutants carried by building discharge water.
We continue to leverage the findings from our 2020
portfolio-wide water risk assessment to identify locations
within our global real estate portfolio that have the highest
levels of water stress and other water-related challenges.(36)
We identify and prioritize high-risk sites and implement
mitigation activities. We also use the analysis to support
context-based water reduction at priority sites. At thehigh-risk facilities identified in the analysis where we are
the customer of contact on the utility invoice, we have
reduced our water consumption by approximately 28%
since 2019, making progress toward achieving our goalof 50% by 2030. For our overall water consumption goal,
we are working to validate our 2019 baseline to ensure
it most accurately reflects The Cigna Group.

In 2022, we shifted from city water to private well waterfor our Bloomfield, Connecticut, headquarters. While thishasn’t affected the amount of water we’re consuming,
the change in how we source water reduces pressure
on public utilities and municipal water sources that arecoming under increasing stress, including suffering system
failures. Sourcing our own water also helps ensure we are
more resilient in the face of our changing climate.

Reducing Waste andSourcing Responsibly
Responsible waste management is an integral part of ourenvironment sustainability strategy, allowing us to reduce
our impacts, improve resilience, and reduce costs. Our focus
is on reducing our waste footprint, with an emphasis on
diverting any waste we produce away from landfills.

To drive progress in this area, our work continued in 2022 to
set a baseline for our waste target and ensure that our target
is not only realistic but will have a meaningful impact across
The Cigna Group. We’re evaluating the most appropriate
methodology to use to capture our baseline, and we plan todevelop a road map detailing how we intend to achieve ourtarget. In the meantime, we continue to prioritize our largest
waste streams and apply best practices in waste disposal andreduction, materials selection, and responsible procurement.
For example, we developed a specialty recycling programfor plastic pill bottles and other unique materials generated
from our four high-volume automated dispensing facilities’operations. In 2022, we were able to recycle approximately
700 metric tons of pill bottles and nearly 1,200 metric tonsof cardboard from our fulfillment centers alone.
We also continued to consolidate our waste contracts, which
will provide better visibility into the waste we’re generating,our disposal methods, and ways to measure this, in addition
to raising more awareness amongst colleagues.

~28%

reduction in water consumption
per square foot at high-risk facilities
where we are the customer ofcontact on the utility invoice,compared to 2019 baseline.

36 We completed a water risk assessment in 2020 using the WRI Aqueduct tool and WWF Water Risk Filter to identify thelocations within our global real estate portfolio that are most vulnerable to external water risks, such as flood, drought,
and stress. Our high-risk facilities are located in Arizona and California.
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We also took the following actions to support
our sustainability targets and reduce our overall
impact on the environment:• Took steps to continue to reduce the amount of
paper mailings and pre-authorization letters by
replacing them with electronic messaging.
• Launched and defaulted digital health insurance
ID cards for our employees as a first phase, andstarted to roll them out to all our customers in 2023.
While physical cards will always be available to those
who need them, we’re seeing positive results withdigital IDs so far. We’re pleased with the numberof customers registering for myCigna® and accessing
digital ID cards.

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H E A LT H Y E N V I R O N M E N T• Introduced a new Print Decision Framework within
our offices with guidance for printing. The expectation
across the enterprise is for printing to become theexception rather than the norm.
• Transitioned to a new food service partnerwith a strong sustainability program and goals,
Compass Group. We are working with Compass to
implement a sustainability plan to eliminate singleuse plastic, and we are developing plans to reduce andcompost all pre-consumer food waste in our cafeterias.
• Reinstated composting at our headquarters inBloomfield, Connecticut, with employees returning backto the office in higher numbers. In just three months,
we composted nearly 8,000 pounds of waste.

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ESG PERFORMANCE METRICS• Implemented an initiative (as of early 2023) at our
Florence, New Jersey, location to reduce the amountof plastic film waste from our wrap seal machines.
• Continued to take a data-driven approachto reducing pharmaceutical inventory waste,(37)such as leveraging new analytics tools to monitor
weather trends and proactively adjust the timingof deliveries to mitigate risk of delays in transit.
• Continued to use our proprietary packaging
software that helps determine the most optimal
packaging type, which can help reduce the amountof material used and the package’s weight, as well
as explored environmentally sustainable packaging
options for coolers, gel packs, and more.

WHERE WE’RE GOING IN SUSTAINABLE OPERATIONS
Employees from The Cigna
Group partnered with the
Kenya Forest Service tohelp plant 100 trees within
the Karura Forest in honorof Earth Day 2022.

Looking ahead, we are implementing an external American
Society of Heating, Refrigerating and Air-Conditioning Engineers(ASHRAE) Level I and II energy audit program focusing on our
most energy intensive sites. We aim to identify and implement
projects that will result in 1%–4% annual energy savings.
We also plan to track and disclose the percentage of our leaseagreements that include green language.

37 Our pharmaceutical inventory waste is defined as any medication and/or medical device, including expired products,
carrier returns that were marked undeliverable, and patient returns due to damage.
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HealthyCompany
We have a deep and long-held commitment tostrong governance as well as ethical and resilientbusiness practices. The strength of our Boardof Directors contributes meaningfully to upholding
these commitments.

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Our Corporate Governance Guidelines set forth the
key governance principles that guide the Board.
These guidelines, together with the charters for the
Board’s Audit, Compliance, Corporate Governance,
Finance, and People Resources Committees, provide
the framework for effective governance to promote
oversight, accountability, and successful outcomes.
See page 10 for information about our ESG governance.

Leadership andAccountability
Our Board is committed
to principles of good
corporate governance.

Board Composition
Our Board comprises directors with the qualifications,skills, and experiences to support our short- and longterm business strategy, provide risk oversight, and ensurecorporate governance practices that best protect theinterests of our stakeholders. As of the end of 2022,
11 directors serve on our Board, each of whom isindependent, with the exception of our Chairman andCEO. With the combination of the Chairman and CEO
roles in 2022, we appointed a lead independent director.
The Corporate Governance Committee ensures that theBoard is composed of individuals with expertise in fields
relevant to The Cigna Group business. Areas of expertise
reflected on the Board include business leadership, finance,
global operations, health services and delivery systems,
marketing and consumer insights, regulated industry/
public policy, risk management, technology operations,and cybersecurity.

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Our Corporate Governance Guidelines also require the
Corporate Governance Committee and any search firm it
engages to include women and racially and ethnically diverse
candidates in the pool from which the committee selects
director candidates. Several board leadership positions areheld by diverse directors, and as of the end of 2022, morethan half of our independent directors are diverse: four are
women, and three are racially or ethnically diverse individuals.
Effective as of June 1, 2023, The Cigna Group appointed
Dr. Philip Ozuah to the Board.
Please see our 2023 Proxy Statement and Corporate
Governance Practices web page for additional information.

Shareholder Engagement
The Board and the Corporate Governance Committee oversee
the company’s shareholder engagement practices. We engage
with shareholders on issues related to corporate governance,
executive compensation, ESG, company performance, andother areas of focus for shareholders. Throughout 2022, beyond
regular engagement with our Investor Relations team, we
invited holders of 74% of our outstanding stock to engage with us,
resulting in engagement with holders of 42% of our outstanding
stock. Summaries of these discussions were shared with ourmost senior leaders, as well as the Board and its committees.

In 2023, we plan to engage our Board further as it relates to ESG and will
share how often our board meetings have an ESG-related update or training.

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Risk Governance and Oversight91%

independent
directors

The Cigna Group has a strong risk management culturethat is maintained through the “tone at the top” from ourSenior Leadership team, mandatory business ethics andcompliance trainings on a variety of material topics, anddepartment-specific training on policies and procedures.
We use a Three Lines Model approach to risk management:

60%

independent
diverse directors

40%

independent
female directors

30%

independent raciallyor ethnically diverse
directors
As of the end of 2022.

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1. The first line includes our business, functional,
process, and project leaders, who are each responsible
for the day-to-day management of risks, controls,
decision-making, and risk evaluation in their respective
areas of expertise.
2. The second line includes oversight from corporate
functions, including Enterprise Risk Management,
Strategy, Corporate Finance, Compliance, and otherareas, which have risk oversight of the first-line roles,
including recommending changes to proceduresor controls and providing perspective on issues andpotential risks.
3. The third line is our Internal Audit function, which
provides independent oversight of the first- andsecond-line roles, performs independent audits andreviews, and makes recommendations to enhance
our risk management activities.
The Board of Directors has ultimate responsibility forrisk oversight under our risk management framework,with each committee having oversight of different areasof risk. Risks not otherwise delegated to a committee are
overseen by the full Board.

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Business
Ethics andCompliance
Earning, building, andmaintaining the trust of ourcustomers, clients, employees,
business partners, andregulators is critical to thesuccess and sustainabilityof our business.

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We strive to meet consistent standards of integrityin everything that we do. Our Ethics, Compliance,and Employee Relations teams play a critical role indriving ethical behavior across our business. Througha company culture that emphasizes ethics and integrity,
we empower employees to be responsible corporate
citizens and support the dignity of workers across ourvalue chain.

Code of Ethics andPrinciples of Conduct
Our Code of Ethics and Principles of Conduct (Code) is thefoundation of our unwavering commitment to integrity,
compliance, and ethical conduct. The Code applies
to all employees, including those covered by collective
bargaining agreements, officers and directors, consultants,
interns, trainees, volunteers, and suppliers. All new
employees, including part-time workers and in-scope
contractors, are trained on our Code as mandated
through our Required Compliance Training Policy.
Furthermore, all employees must affirm their adherence
to our Code annually. Our Board of Directors is also
trained on their obligations under the Code and the
Director Code of Conduct.

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Oversight and GovernanceWith oversight from our Ethics and Compliance teams,
we review and update our Code on an annual basis.
In 2022, we updated language about required internal
reviews before employee speaking engagements andadded references to our Supplier Code of Ethics andonline forms for disclosure of potential conflict.

Fundamental Human Rights For All
Our Human Rights Statement outlines ourcommitment to human rights, which is guided by
the laws of the United States as well as the United Nations
Guiding Principles on Business and Human Rights
and the International Labor Organization’s Declaration
on Fundamental Principles and Rights at Work.

Anti-Bribery and Corruption
At The Cigna Group, we take anti-corruption compliancevery seriously. As stated in our Code, it is The Cigna Group
policy to conduct business ethically, to prohibit bribery of
government officials in connection with our business, andto avoid any conduct that creates even the appearance ofimproper interaction with a government official. Government
officials include not only the regulators who oversee The
Cigna Group business but also employees of government
entities that we work with on a regular basis, including
public hospitals, school districts, and government agencies.

The Cigna Group also maintains an Anti-Corruption
Compliance Policy. In 2022, we created new, interactive
policies and accompanying manager toolkits that govern
gifts and entertainment for government officials and otherthird parties in our International Health segment.
We require certain employees, such as those in high-risk
geographies, to receive further training on anti-corruption
principles and our Anti-Corruption Compliance Policy.
All employees who are assigned anti-bribery and corruption
training are required to complete such training that is
appropriate to their role, operating environment, andjurisdiction. In 2022, we customized our anti-corruption
training with learning scenarios specific to our businessmodel and risks.
To proactively stay abreast of anti-corruption bestpractices globally, we are members of TRACE International,
a globally recognized anti-bribery business association,
and Gartner, a general resource for compliance, ethics,
and anti-corruption.

Creating a culture of integrity and ensuring compliancewith our Code and other policies, laws, and regulations is
an enterprise-wide responsibility. Our Chief Compliance
Officer and our Ethics Office are responsible for designing,
implementing, and monitoring adherence to our Code andrelated policies, as well as other programs built to reinforce
our commitment to integrity and compliance.
The Compliance organization regularly reviews compliancerequirements and conducts compliance risk reviews to
identify potential or emerging risk areas and evaluate anychanges needed to our Code, policies, and training. The
Chief Compliance Officer also serves as the Chief Risk Officer,
and compliance risk reviews are actively included in theenterprise risk assessment process. The Chief Compliance
Officer and the General Counsel meet regularly with theCompliance Committee of the Board of Directors to review
key compliance topics, including any significant investigative
matters, and to reinforce oversight for ethics and complianceat the highest level of the organization.

Creating a culture of integrity and ensuring compliancewith our Code and other policies, laws, and regulations is anenterprise-wide responsibility.

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Reporting Concerns
Our employees are also responsible for complianceand ethics, and we emphasize, through targetedcommunications, training, and awareness activities,
their duty to report actual or suspected misconduct,whether by other employees or third parties. For example,
Code Hits & Misses is a monthly global communication
series on our intranet highlighting real but anonymous
stories of ethical missteps by employees. The series
reinforces lessons learned, key policies, and the importanceof speaking up and contacting the Ethics Office forassistance—and it’s one of our most-viewed series
compared to other intranet articles.

To encourage such reporting, The Cigna Group provides
a confidential, anonymous (where permitted by law)
Ethics Help Line available to employees globally, 24/7.
The Ethics Help Line includes a corresponding websitethat addresses questions and facilitates reporting concerns
or instances of potential misconduct. In 2022, we received
approximately 2,500 reports, disclosures, and requests
for guidance through the Ethics Help Line or directly to
the Ethics Office via our Duty to Report and Open Door
Policies. Only approximately 17% of the reports weremade anonymously, exceeding benchmarks of similarly
situated companies, and this can be interpreted to indicate
employee trust in The Cigna Group. Approximately 44%of the reported matters raised human resources–related
questions or concerns and were handled by our Employee
Relations team. Of the matters handled by the Ethics Officeand our Enterprise Investigations team, approximately
58% were found to be substantiated, exceeding
available benchmarking. All substantiated reports
resulted in either training, coaching, policy reviews,
or disciplinary action.
The Cigna Group strictly prohibits retaliation against
anyone who reports, in good faith, suspected violationsof our Code, principles, or other compliance concerns
and against anyone who participates in any investigationof related matters, as detailed in our Protection Against
Retaliation Policy. We reinforce this prohibition throughregular communication with our managers and employees.
Employees who engage in retaliation are subject todisciplinary action up to, and including, terminationof employment.

WHERE WE’RE GOING IN BUSINESS ETHICS AND COMPLIANCE
Looking ahead, we are exploring conducting a formal Human Rights
Impact Assessment to identify and assess potential human rights
impacts across our enterprise and value chain.

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INTRODUCTION

H E A LT H Y S O C I E T Y

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

Data
Protection
As a global health company,
we collect, store, and process
a high volume of sensitive
data in connection with theservices we provide.

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

We understand the critical importance of securing personal
information and maintaining a robust and agile dataprotection program in an ever-evolving landscape.
We take the trust our clients and customers placein us very seriously and are committed to protecting
their information.
We operate in many jurisdictions and are responsible
for complying with the laws and regulations governing
the collection, storage, use, processing, transfer, disclosure,and destruction of personal information in each of thesejurisdictions. We follow these legal obligations and maintaina privacy and information protection program that aligns
with global industry best practices and standards.

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H E A LT H Y S O C I E T Y

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Oversight and Governance

Privacy

In addition to the Board of Directors Audit and Compliance
Committees’ oversight of our data protection programs
and strategy (see page 10), our Cyber and Privacy Council(CPC) manages the company’s cybersecurity and data
privacy risks. The CPC is led by members of The Cigna
Group Senior Leadership team, including the Global
Chief Information Security Officer (GCISO), the Chief
Privacy Officer, and the Chief Compliance and Risk
Officer. Responsibilities for the CPC include approving
our cybersecurity and privacy strategy, road map, andbudget; setting the organization’s priorities; and drivingalignment with strategic business initiatives.

Protecting the privacy of our customers, patients, clients,
employees, and partners is of the utmost importanceto us. The Cigna Group Code of Ethics and Principles
of Conduct (see page 58) outlines our obligations toprotect personal information across all parts of our business.
In addition to training our employees about our Code,
we also provide specific data protection training andemphasize the responsibility of every employee to ensure
the privacy of our stakeholders by adhering to our company’s
data protection policies and practices.

The Cigna Group Information Protection team (CIP), under
the leadership of the GCISO, collaborates closely with theregional Chief Information Security Officers (CISOs), eachmanaging their respective business segments. Together,
this group of cybersecurity leaders provides guidance on theimplementation of risk protections, processes, and controls
with respect to data across the organization. CIP is dedicatedto securing member, client, provider, and company data
while enabling speed, scale, and trust. CIP leadershipregularly reports to the Board to ensure cybersecurity
and data privacy risks are effectively managed.
We also recognize that data protection must be a crossfunctional endeavor that spans across our business. In
partnership with our Enterprise Risk Management programand Internal Audit function, we identify, assess, manage,
and control risks that have an impact on our ability toachieve strategic and financial goals. Our collective efforts
drive privacy and security compliance across the enterprise.

For our customers, we provide online resources about
our privacy and information protection practices,
including our Online and Mobile Privacy Statement,
Notice of Privacy Practices, and Privacy Forms. The Cigna
Group notifies customers about how their personal
information may be used and disclosed by The Cigna
Group, as well as their rights. In addition to notifying
customers and clients of any changes to our privacy
practices, we also tell customers how they can takeadditional steps to protect their personal information.
In 2022, The Cigna Group focused on employee andcontractor training and continued to update privacy
incident response plans. We also engaged an outside
consultant to evaluate the key risks and controls that arepart of our enterprise-wide privacy program. We enhanced
our privacy governance practices by implementing new
and improved monitoring and tools to protect personal
information. In addition, we expanded customer rights
to their data to prepare for evolving U.S. privacy legislationin 2023 at the state level.

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS• Developing policies that support
our governance and use of personal
information in addition to providing
advice on strategic initiatives.
• Monitoring privacy and security laws
and regulations and updating policies
as necessary as well as communicatingchanges to such policies.
• Managing privacy risk andreporting privacy-related risks to
The Cigna Group management.

Our
enterprise
privacyprogram is
responsiblefor:• Creating and maintaining privacy
training and privacy awarenessefforts to educate employees about
the importance of handling personal
information with care.
• Providing legal guidance on
information incidents, breaches,and complaints and contractingwith third parties that process personal
data on behalf of The Cigna Group.
• Investigating and responding topotential privacy incidents while
overseeing corrective action plansand providing required notifications.
• Ensuring compliancewith applicable breach laws.
• Monitoring the effectivenessof the privacy programs.

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H E A LT H Y S O C I E T Y

Responsible Augmented
Intelligence through Model
Equity Governance
At The Cigna Group, we use algorithms and predictivemodels to help direct health care decision-making andimprove health outcomes for our customers. It’s importantthat these tools are used appropriately to avoid inadvertentbias and discrimination while taking into accountdemographic information that has medical relevance.
To ensure our practices and solutions are consistent withour commitment to health equity, we have a dedicatedteam and governance structure in place, known as Model
Equity Governance. The mission of the program is toinstitute and apply the highest standards for the use of
equitable augmented intelligence in how we provide
health products and services to our customers and clientsand preserve flexibility in the use of models to improve thehealth and vitality of those we serve.
This team has defined best practices and developed acomprehensive procedure for model equity and algorithmic
bias identification and mitigation, which is outlined inour enterprise-wide Model Equity Governance Policy. The
Policy is governed by our Model Equity Governance Board,
comprised of senior leaders from across the enterprise.
In 2022, we continued to work with partners across ourbusiness to test for potential inadvertent bias in predictivemodels and mitigate the risks while enforcing our Policy.
We also began deploying automation tools to speed up
and improve accuracy of model review.
38 The SOC 2 framework is published by the American Institute of Certified Public Accountants (AICPA) and is the voluntary
cybersecurity framework most widely used by service organizations with primarily U.S.-based customers. Our SOC 2
audits are scoped to assess key controls within select core systems and do not encompass our entire environment.

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

We intend to expand and strengthen our Model Equity
work over the coming years, expanding the scope of ourability to improve the lives of our customers and the qualityof the products and services that we provide.

Cybersecurity
Our Governance, Risk, and Compliance platform hosts all
our information protection policies and standards. These
policies and standards are regularly reviewed and updated
both in response to the dynamic landscape and to facilitate
compliance with international, regulatory, industry, andcontractual requirements and recommendations.
Assessments by an independent third party are performed
regularly against the SOC 2 framework,(38) which provides
an objective evaluation of our internal processes andcybersecurity controls. Benefits of these audits include
thorough independent reviews to help ensure that wehave adequate and effective controls to secure andprotect sensitive data and the facilitation of continuous
improvement of our security posture.
Core to our security model is our defense-in-depth
framework, comprising multiple layers of processes andtechnologies that help prevent, detect, and respond to

DATA

ACCESSCONTROLS

ENDPOINTCONTROLSAPPLICATIONCONTROLSH E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

threats. Our approach to safeguarding against external
threats incorporates a suite of preventive technologies,
including malicious email blocking, defenses against
automated attacks, and multifactor authentication.
These strategies act to proactively intercept and neutralize
cyber threats to help ensure data remains secure within
our environment. Event monitoring technologies run
continuously, detecting intrusion attempts and alerting
our Cybersecurity Incident Response team.
In 2022, we:• Further enhanced monitoring, detection, and response
efforts through technologies and automation.
• Tested and improved our incident response plans,
playbooks, and supporting materials through tabletop
exercises with key stakeholders across the business.
• Increased visibility of our incident response programwith senior leadership and other stakeholders.
• Rolled out continuous training to ensure global threat
management employees, cross-functional stakeholders,and other response support areas stay current with theever-evolving threat landscape.

NETWORKCONTROLSPHYSICALENVIRONMENTCONTROLSOPERATION AND
ORGANIZATIONCONTROLS

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H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

The Cigna Group undertakes the following critical security processes to mitigate and protect against cybersecurity risks:• Cyber Risk Assessments – We routinely analyze
our network and information systems to assess
improvement opportunities to further enhance ourrisk mitigation. Subsequent reports are used by senior
management to make informed decisions about whereto allocate resources to reduce cyber risks and improveoverall security.
• External Audits and Benchmarking – The effectivenessof our overall cybersecurity program is frequently
evaluated by independent firms through various levelsof controls assessments. We also perform an annual
maturity assessment and benchmark our security
controls to identify opportunities to strengthen our
cybersecurity program.
• Security Operations and Monitoring – Our operational
monitoring processes provide valuable insight into theeffectiveness of our security program. A centralized
system collects security logs and performs event
correlation that creates an alert if a trigger occurs.
We review any deviations from our established targets
and implement corrective actions.
• Identity and Access Management – Employees areprovided with the minimal amount of access required
to perform their jobs using role-based access control
methodology, which defines access to our information
systems based on job function. Privileged or elevatedaccess to our systems is subject to supplemental approvalrequirements, increased authentication processes,
and additional logging and monitoring.

• Security Awareness and Training – Events andeducation activities are hosted throughout the year,
such as Cybersecurity Awareness Month, videos,training programs, and frequent phishing simulations.
The Cigna Group continuously trains workforce memberson the importance of preserving the confidentiality
and integrity of customer data. All new hires havemandatory information protection and privacy training
as part of their onboarding, and all employees complete
an annual cybersecurity refresh training.
• Third-Party Security Oversight – Suppliers that haveaccess to, host, or transmit The Cigna Group data arecontractually required to comply with our Security
Policies and Standards. Additionally, suppliers may besubject to periodic security audits or risk assessments,
which include security questionnaires, security
capabilities and maturity assessments, controls evidence
reviews, application vulnerability assessments, public
internet presence monitoring, and alignment reviews
with service-specific industry standards (e.g., NIST,
ISO, HIPAA, and Payment Card Industry standards).
Follow-up activities are performed as needed to discussobservations, track issues, and ensure remediation plans
are completed to maintain compliance.
• Cybersecurity Incident Response Planning – Our
Cybersecurity Incident Response team, comprising bothtechnical and management personnel, determines theseverity of a validated cybersecurity event and coordinates
the response plan. Incident handling procedures dictateactions during each phase, which include communications,actions to be performed, methods of operation, andcontingencies for unanticipated outcomes.
• Business Continuity and Disaster Recovery –Just as with any crisis or emergency, a quick andeffective response to a cybersecurity event is criticalto protect information and to reduce disruptionsof normal business operations. Using industry bestpractices and continuous improvement principles,
we validate strategies, document business recovery plans,
and test these procedures enterprise-wide annually.

WHERE
WE’RE GOING
IN DATAPROTECTION

The cybersecurity and privacy space isever evolving. We will continue to review
and update our data privacy and security
policies at least annually, maintain nearly
100% workforce completion of cybersecurity
and privacy training, and meet regulatory
timeframes when responding to Data
Subject Access Requests (DSARs).
We also aim to report metrics such as:• Percentage alignment of NIST SP 800-53
Security Control Baseline Moderate• Number of malicious emails blocked• Number of data loss events prevented• Number of penetration tests completed

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H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

Supplier Governance and Risk

Responsible
Supply Chain
As we drive sustainability
across our operations, we lookto ensure our indirect supply
chain (procured goods andservices to support our dayto-day operations) and direct
supply chain (procured goods
and services to be delivered toour customers) embody our ESG
aspirations and commitments.

Reviewed annually, our Supplier Code of Ethics outlines
the expectations we have of our vendors to mitigate theirenvironmental impact and maintain workplaces that
respect human rights. Potential vendors must read andattest that they comply with our Supplier Code of Ethics,
and that attestation is standard in all our indirect suppliercontracts. We also have an Ethical Procurement Policy toguide the procurement actions of our own employees. This
policy includes a specific section on ESG, including topics
such as DEI, environmental stewardship, global citizenship,labor rights, and transparency.
To proactively manage supply chain risks, we leveragea third-party risk management software platform thatscreens suppliers before we onboard them. The screening
evaluates suppliers across a number of different risk
dimensions, including risks related to financial solvency,
compliance, data protection, and adverse media. In 2022,
we added several ESG-related topics to the screening tocapture additional environmental and social aspects.
Suppliers are also required to complete a questionnaireon potential risks and hazards specific to their contract
engagements, including materiality, operational readiness,data protection, and strategic importance. For our suppliers
under management,(39) we provide ongoing management
encompassing contract adherence, contract performance,and supplier risk/issue mitigation. This includes conducting
performance reviews, establishing and managing corrective
action plans when needed, and continued, ongoing
screening for potential negative impacts.

39 Suppliers under management include indirect suppliers that were selected based on relationship segmentation,
criticality to our operations, and risk profile. Suppliers under management represent a majority of our indirect spend.
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H E A LT H Y S O C I E T Y

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

Supplier Sustainability

Supplier Diversity

We continue to use EcoVadis, a third-party management
tool, to comprehensively assess our suppliers’ ESG businesspractices, including topics across environment, laborand human rights, ethics, and sustainable procurement.
Our initial focus is on a selected list of suppliers undermanagement, and through 2022, approximately 57%
of them have been rated by EcoVadis.

By 2025, we aim to increase our indirect annual diverse
supplier spend to $1 billion, representing nearly 20%
of our $5 billion indirect spend in the United States.(40)
In 2022, we made significant progress against this target,
growing our diverse spend by 20% compared to 2021.
As a result, The Cigna Group was recognized with the
Forefront 50 honor, which acknowledges companies thatare leading the way to create greater economic access andequity for systemically excluded entrepreneurs of color.

In early 2023, we started incorporating specific language
in our supplier contracts that sets expectations to complete
the EcoVadis Sustainability Assessment, and we intend
to do the same in our supplier requests for proposal.

2022 diverse supplier economic impact(41,42)~$662M

in Tier 1
diverse spend

40
41
42
43

~$259M

in Tier 2
diverse spend(43)~$1.2B

in economic
contributionsdelivered throughthree channels:
direct, indirect,
and induced~2,500

jobs supported atsmall and diverse
suppliers~$262M

in earnings
through jobs
with small anddiverse suppliers

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

In early 2023, our second cohort graduated fromThe Cigna Group Supplier Mentor Protégé Program.
This 18-month program pairs diverse suppliers with
The Cigna Group executives to develop strategies tostrengthen and expand their businesses. This includes
one-on-one monthly meetings and quarterly onsite
forums to learn industry best practices from subject
matter experts.

As part of our supplier diversity program,
we are a member of the following nationalorganizations:• National Minority Supplier Development Council (NMSDC)• Women’s Business Enterprise National Council (WBENC)• National LGBT Chamber of Commerce (NGLCC)• Disability:IN• National Veteran Business Development Council (NVBDC)

Our aspirational goal is in no way a quota. All decisions regarding vendor engagement are made without discrimination on the basis of race, gender, sexual orientation, disability, or any other protected characteristic.
Economic impact statistics are approximations from a preliminary data report provided by our third-party source for economic impact modeling, which develops estimates of spending, income, and employment impacts.
Tier 1 suppliers include those that The Cigna Group pays directly for the goods and services rendered. Tier 2 suppliers include those that are subcontractors to the Tier 1 suppliers.
Procurement spend that our Tier 1 suppliers report from their small and diverse suppliers. By encouraging our Tier 1 suppliers to do business with diverse suppliers and share this information with us, we reflect a portion of this spend in our Tier 2 program.

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H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

Drug Sourcing
The goal of our direct supply chain is to source thehighest-quality pharmaceuticals for our customers whilenegotiating agreements that help lower overall health carecosts for clients and customers. With the importance ofpharmacy in mind, three distinct committees, comprisingboth internal and external experts, develop our standard
formularies, which are lists of covered medications.
We also have a dedicated team within our EvernorthSupply Chain group that manages rebate management,
retail pharmacy networks, and pharmaceuticalprocurement for our owned pharmacies.
To drive product safety and quality across our direct supply
chain, we maintain and adhere to written policies andprocedures for the receipt, security, storage, inventory,
and distribution of prescription drugs. This includes
policies and procedures for identifying, recording, andreporting losses or thefts and for correcting errors andinaccuracies in inventories. We also maintain policies andpractices designed to prevent counterfeit medications
by tracking and tracing products from the point of
manufacture to the point of sale.
Our Risk Mitigation team regularly conducts risk analyses
specifically related to drug sourcing, which are critical tomonitoring production levels, supplier challenges, andother important inputs to our direct supply chain.

WHERE WE’RE GOING IN RESPONSIBLE SUPPLY CHAIN
Looking ahead, we will seek to proactively collaborate with supplierson EcoVadis, establish more-robust ESG screening criteria andsubsequent monitoring practices, and set goals related to environmental
performance as an outcome of our Scope 3 emissions inventory and plan.

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H E A LT H Y W O R K F O R C E

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H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

ESG Performance
Tables andReporting IndicesThis report is aligned to the SASB Managed
Care and Professional and Commercial Services
Industry Standards and GRI. The report also
leverages the recommendations of TCFD andserves as our Communication on Progress asa member of the UN Global Compact.

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H E A LT H Y W O R K F O R C E

Performance Tables

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

Healthy Workforce

Healthy Society

Employee Health,
Safety, and Vitality

2022

2021

2020

2019

2018

Safety incident rate

0.730(45)

0.410

0.410

0.600

0.400

Sustainable Health Care

2022

2021

2020

2019

2018

Accountable care programs

~240

~235

~240(44)——

Diversity, Equity, and Inclusion within Our Workforce—

The data in this table represents U.S. employees only, and the categories alignwith the U.S. EEO-1 job categories.(46)Primary care providers invalue-based care arrangements~126,000~110,000~99,000—

Customers in value-based
arrangements~3M

Community Resilience

2022

2021

2020

2019

2018

Financial impact fromThe Cigna Group giving (total)

$54M

$50M

$81M

$40M

$24M

Employee volunteer hours~57,000~59,000~57,000~93,000~81,000

~3M

—

—

—

44 We previously reported ~700 accountable care programs for 2020. This was incorrect because it included our full count of collaborative care arrangements rather thanaccountable care programs only.
45 We attribute the increase in our 2022 safety incident rate to the Omicron variant of COVID-19 in early 2022. Several health care professionals who tested positive with either
asymptomatic or minor symptoms had to be sent home to quarantine, which is noted as a recordable injury. More than half of our recordable cases in 2022 were COVID-19
related. With COVID-19 recordable cases removed, our safety incident rate dropped to 0.27, well below our 2021 rate.
46 Because U.S. EEO-1 data collection is scheduled to open in mid-July 2023, our above reported percentages may differ from the EEO-1 report issued in August (or later)
2023. The above data excludes employees who chose not to identify gender or race/ethnicity, whereas the U.S. EEO Commission does not recognize “unidentified” as acategory. Our latest EEO-1 will be available on our website at this link.
47 Totals do not include employees who chose not to identify gender or race/ethnicity.
48 “Ethnic minorities” includes Black/African American, Hispanic or Latino, Asian, Pacific Islander, American Indian/Alaskan, and employees who identified as two or more races.

Total U.S. Workforce(47)

2022

2021

2020

2019

2018

Women

72%

71%

76%

77%

73%

White

61%

64%

63%

66%

73%

Ethnic minorities(48)

39%

36%

37%

34%

27%

Executive/Senior-Level Officials

2022

2021

2020

2019

2018

Women

38%

35%

35%

31%

35%

White

87%

86%

88%

90%

83%

Ethnic minorities(48)

13%

14%

12%

10%

17%

First-Mid-Level Officials

2022

2021

2020

2019

2018

Women

59%

58%

60%

57%

52%

White

74%

75%

76%

78%

81%

Ethnic minorities(48)

26%

25%

24%

22%

19%

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H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

Human Capital Development
Professionals
Women
White

2022
66%
68%

2021
66%
71%

2020
71%
70%

2019
66%
74%

2018
72%
76%

Ethnic minorities(48)

32%

29%

30%

26%

24%

Sales Workers

2022

2021

2020

2019

2018

Women

72%

71%

75%

70%

55%

White

69%

72%

71%

74%

78%

Ethnic minorities(48)

31%

28%

29%

26%

22%

Total Number
Of Employees

2022(50)

2021

2020

2019

2018

Total

71,27070,65371,001

71,74545,288

Employees by Region

2022

2021

2020

2019

2018

United States

94%

90%

90%

90%

86%

International

6%

10%

10%

10%

14%

Employees by Type

2022

2021

2020

2019

2018

Full-time

97%

98%

98%

98%

98%

Part-time

3%

2%

2%

2%

2%

Employees by Gender

2022

2021

2020

2019

2018

Women

71%

70%

70%

70%

71%

Men

29%

30%

30%

30%

29%

Employees by Age

2022

2021

2020

2019

2018

Under 30

12%

12%

13%

13%

14%

Administrative
Support Workers

2022

2021

2020

2019

2018

Women

87%

85%

90%

81%

83%

White

45%

50%

48%

54%

66%

Ethnic minorities(48)

55%

50%

52%

46%

34%

All Others(49)

2022

2021

2020

2019

2018

30–50

56%

57%

57%

56%

57%

Women

77%

72%

77%

73%

89%

Over 50

32%

31%

30%

31%

29%

White

46%

48%

44%

54%

61%

Unionized Employees

2022

2021

2020

2019

2018

Ethnic minorities(48)

54%

52%

56%

46%

39%

Total

1%

<2%

—

—

—

48 “Ethnic minorities” includes Black/African American, Hispanic or Latino, Asian, Pacific Islander, American Indian/Alaskan, and employees who identified as two or more races.
49 “All Others” includes EEO-1 job categories for technicians, operatives, and service workers.
50 We updated our calculations in 2022 to include all employees; previous years’ human capital development data include only regular employees.
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Total Number
Of Employee Hires
Total

INTRODUCTION

H E A LT H Y S O C I E T Y

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

Healthy Environment(54)2022
16,6892021
13,1362020
12,864

2019
10,8532018
7,044

Hires by Region

2022

2021

2020

2019

2018

United States

89%

86%

83%

—

—

International

11%

14%

17%

—

—

Climate Change and Emissions

2022

2021

2020

2019(55)2018

Total GHG Scope 1 and 2
emissions (location-based) –mtCO2e(56)101,424

111,107(57)128,949

133,70269,953

Total GHG Scope 1 and 2
emissions (market-based) –mtCO2e74,230107,133

128,949

133,70269,953

Hires by Gender

2022

2021

2020

2019

2018

Women

77%

75%

72%

72%

70%

Scope 1 emissions

14,566

12,537(57)12,687

16,671

10,961

Men

23%

25%

28%

28%

30%

Hires by Age

2022

2021

2020

2019

2018

Scope 2 emissions(location-based)

86,85898,570116,261

117,032

58,992

Under 30

32%

31%

35%

36%

32%

59,664

94,596116,261

117,032

58,992

30–50

55%

55%

50%

50%

54%

Scope 2 emissions(market-based)

Over 50

13%

14%

15%

14%

14%

Emissions intensity –mtCO2e/sq ft(58)

0.011

0.010

0.011

0.012

0.011

Hires by Ethnicity

2022

2021

2020

2019

2018

10,535

2,822

8,394

23,693

21,371Ethnic minority

58%

56%

—

—

—

Scope 3 emissions(59)(Business travel only)

Additional Human Capital
Development Information

2022

2021

2020

2019

2018

Open positions filled
by internal candidates(51)

66%

62%

63%

—

—

Voluntary turnover rate(52)

16%

16%

10%

—

—

Average hours of training
per employee(53)

34

27

35

30

20

51 Does not include entry-level positions.
52 We updated our calculation in 2022 to include all employees; previous years’ turnover rates included only exempt employees in the United States. Years 2020 and 2021 have been updated toreflect the new calculation.
53 In previous years we calculated our average learning hours per employee by using the average hours reported in the annual Association for Talent Development State of the Industry reportand adding the actual hours of learning captured in our systems. In 2022, we updated our methodology to only include our internal data, which we feel is a more accurate depiction of learning
activity across the enterprise. Previous years’ data has been restated to reflect this update.
54 Limited assurance of bold data points has been provided by ERM CVS. Please see the assurance statement on page 97 for further details.
55 Please note that the number of The Cigna Group properties in our real estate portfolio increased in 2019 due to the integration of the Express Scripts portfolio, resulting in an increase inemissions, energy, and water.
56 Emissions intensity is calculated using location-based emissions and on a square foot basis. Scope 1 and 2 emissions are calculated using an operational control consolidation approach.
Sources of emissions deemed to be de minimis are omitted, including diesel fuel generators and refrigerants. All GHG emissions are calculated in accordance with the guidance set out by
the GHG Protocol. The sources of our emission factors include the U.S. EPA, Intergovernmental Panel on Climate Change (IPCC), and the International Energy Agency (IEA). Where primaryactivity data was not available, we used an extrapolation methodology to make estimations by considering site type, historical usage, square footage, geography, and other factors.
57 The 2021 GHG emissions and Scope 1 emissions values have been restated to reflect a corrected data input value for the 2021 fleet emissions that was previously overstated.
58 The Cigna Group global real estate portfolio has a footprint of approximately 9.8 million square feet as of the end of 2022. Approximately 9 million square feet are considered our operationalboundary, which is used for our intensity calculations.
59 We updated our 2022 Scope 3 business travel emissions shortly after our original 2022 ESG Report publication on July 10, 2023. We adjusted the value to more accurately and consistently
apply the UK’s Department for Environment, Food & Rural Affairs (DEFRA) methodology.
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Healthy Company
Climate Change and Emissions

2022

2021

2020

2019(60)

2018

Revenue

2022

2021

2020

2019

2018

Energy consumption – MWh

300,497

302,627

329,733

362,910207,152

Global revenue$180.5B$174.1B$160.4B$153.6B$48.7B

Direct energy consumption

75,07866,03865,622

83,072

63,130

Leadership and Accountability

2022

2021

2020

2019

2018

Indirect energy consumption

225,418

236,589

262,616

261,794

144,022

Independent directors

91%

91%

92%

92%

91%

Energy intensity – MWh/sq ft(61)

0.033

0.029

0.030

0.031

0.033

Independent female directors

40%

40%

27%

18%

17%

Sustainable Operations

2022

2021

2020

2019

2018

30%

30%

27%

27%

25%

Global real estate footprint – sq ft~9.8M~11.9M~11.1M~11.1M~7.7M

Independent racially or
ethnically diverse directors

Water withdrawals – kgal

185,956

187,901

236,662

266,964

92,614

Independent diverse directors

60%

60%

55%

45%

42%

Water intensity – kgal/sq ft(61)0.020

0.018(63)

0.021

0.024

0.016

Responsible Supply Chain

2022

2021

2020

2019

2018

Tier 1 diverse spend~$662M~$582M~$520M——

Tier 2 diverse spend~$259M~$182M~$125M——

Economic contributionsdelivered through direct,
indirect, and induced channels~$1.2B~$1B~$980M~$865M~$473M

Jobs supported at small anddiverse suppliers~2,500~3,350~3,150~3,000~1,700Earnings through jobs withsmall and diverse suppliers~$262M~$195M~$190M~$175M

~$84M

(62)

(63)

60 Please note that the number of The Cigna Group properties in our real estate portfolio increased in 2019 due to the integration of the Express Scripts portfolio, resulting in an increase inemissions, energy, and water.
61 The Cigna Group global real estate portfolio has a footprint of approximately 9.8 million square feet as of the end of 2022. Approximately 9 million square feet are considered our operationalboundary, which is used for our intensity calculations.
62 Water withdrawal data includes only international locations where primary data is available.
63 The 2021 water withdrawal and water intensity values have been restated to reflect a corrected data input value for an office property in Troy, NY that was previously overstated.

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H E A LT H Y S O C I E T Y

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

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SASBManaged Care
Customer Privacy and Technology Standards
HC-MC-230a.1—Description of policies and practices tosecure customers’ protected health information (PHI)
records and other personally identifiable information (PII)The Cigna Group privacy policies and information security
program require that every member’s personal information
be safeguarded and kept confidential in accordance with allapplicable laws, including the Health Insurance Portability
and Accountability Act (HIPAA)/Health Information
Technology for Economic and Clinical Health Act (HITECH).
These policies apply to every employee, agent, and director.
Highlights of the corporate privacy policies include:• PHI and PII are collected only as necessary and throughethical means.
• PHI and PII are used and disclosed only as permitted or
required by, and in accordance with, the requirements
of applicable law, including laws requiring prior notice
to or consent of the member.
• The minimum amount of PHI and PII will be usedor disclosed as necessary to accomplish the purposeof the permissible use or disclosure.
• Every employee and business associate is responsible
for protecting the personal information of individuals
and complying with the privacy policies.
• The Cigna Group and its subsidiaries will not sell, rent,
or license PHI and PII unless authorized by the subjectof the personal information or permitted by law to do so.

• Internal sharing of PHI and PII is permitted only ifallowed by law and a legitimate business need exists.
If the purpose of sharing the information is not clearlyconsistent with the purpose for which the PHI and PII
were collected, approval of the Privacy Council is required
prior to sharing the PHI and PII.
• The Cigna Group maintains a detailed and extensive
information security program, including industry bestpractices and technology, to protect the security andintegrity of personal information. The Cigna Group complies
with all federal and state privacy laws, including all aspectsof HIPAA. Like any large health care organization, The
Cigna Group receives complaints and inquiries fromclients, members, patients, or regulatory agencies alleging
potentially improper or unauthorized use or disclosure of
PHI or PII. The Cigna Group will promptly investigate andremediate any reported cases of improper or unauthorized
use or disclosure of PHI and PII, including those reported
as a breach under HIPAA/HITECH or pursuant to applicablestate law. While these individual cases may require
disclosure to regulatory agencies, clients or individuals, inthe past three years, The Cigna Group has not experienced
any material (as defined by whether it meets the thresholdrequiring disclosure in the company’s public reports filedwith the Securities and Exchange Commission) data breachor compromise of its information systems. Refer to the Data
Protection section of this report for more information.

HC-MC-230a.2—(1) Number of data breaches, (2)percentage involving (a) personally identifiable
information (PII) only and (b) protected healthinformation (PHI), (3) number of customers affectedin each category, (a) PII only and (b) PHI
The Cigna Group reports required data breaches to the
U.S. Department of Health and Human Services, Officefor Civil Rights. Please refer to the U.S. Department of
Health & Human Services—Office for Civil Rights.

Access to Coverage
HC-MC-240a.1—Medical Loss Ratio (MLR)
Our MLR for the time period ending December 31, 2021,
was 89%. MLR is calculated using a three-year average,
which aligns with CMS reporting guidance. Due toreporting timelines, this information will always bereported a year behind.
HC-MC-240a.2—Total amount of rebates accrued andpaid due to noncompliance with the Patient Protection
and Affordable Care Act for Medical Loss Ratio (MLR)
The Cigna Group had $19.2M accrued MLR rebates asof December 31, 2021, and paid $69.8M MLR rebates
during the twelve months ended December 31, 2021.
Due to reporting timelines, this information will always
be reported a year behind.
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HC-MC-240a.3—Percentage of proposed rateincreases receiving “not unreasonable” designationfrom Health and Human Services (HHS) review
or state review
100% of proposed rate increases received“not unreasonable” designation from HHS review.

Plan Performance
HC-MC-250a.1—Average Medicare Advantage plan
rating for each of the following plan types: (1) HMO,
(2) local PPO, (3) regional PPO, (4) PFFS, and (5) SNP
Cigna Healthcare average 2023 Medicare Advantage Star
ratings as released in October 2022 were as follows:• HMO: 4.5 (out of 5)• Local PPO: 3 (out of 5)• Regional PPO: N/A• PFFS: N/A(64)• SNP: 4 (out of 5)(65)

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Improved Outcomes
HC-MC-260a.1—Percentage of enrollees in wellness
programs by type: (1) diet and nutrition, (2) exercise,(3) stress management, (4) mental health, (5) smoking
or alcohol cessation, or (6) other
The Cigna Group offers a number of programs to help improveoutcomes for enrollees. Approximately 58% of Cigna Healthcare
U.S. Commercial risk-based enrollees are eligible to participate
in our Health Advisor(66) and Lifestyle Management Programs.(67)
HC-MC-260a.2—Total coverage for preventive healthservices with no cost sharing for the enrollees, total
coverage for preventive health services requiringcost-sharing by the enrollee, percentage of enrollees
receiving Initial Preventive Physical Examinations (IPEE)
or Annual Wellness Visits (AWV)
Background information: Every group medical plan falls
under a Health Care Reform (ACA) status:• Non-Grandfather: ACA applies. Preventive health services
covered at 100% in-network; no dollar maximum.
• Grandfather: Only some ACA rules apply. Preventive
health services covered at cost-share or 100% in-network;
no dollar maximum.
• Exempt: ACA does not apply. Client choice to exclude
preventive health services or cover at cost-share or 100%in-network. An annual dollar maximum may be applied.

64 Cigna Healthcare is not currently contracted with CMS to administer Regional PPO or PFFS plans.
65 SNP: Score is based on an enrollment weighted average of the SNP population within applicable contracts that earneda Star rating for the 2022 plan year.
66 The Health Advisor® program identifies both at-risk and seemingly healthy individuals who exhibit unhealthy behaviors.
Through one-on-one coaching, we guide customers to make lifestyle changes, close gaps in care, and help themchoose cost-effective treatments.
67 Lifestyle Management Programs provide support and coaching with a focus on setting goals, overcoming barriers,and providing the resources and motivation to be successful. Programs include phone-based and online coaching forweight, tobacco cessation, and stress management.

Some clients with Grandfather and Exempt plans embrace
preventive care and choose voluntarily to cover at 100%in-network. Therefore, the percentage of plans that apply
cost-share or do not cover preventive care is lower than thepercentage in these statuses.

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Based on the above considerations, we estimate
the following:• Approximately 96% of our plans cover preventive
care at 100%.
• Approximately 4% of our plans cover preventive care
at cost-share. A small subset percentage of theseplans may impose an annual dollar maximum, limit theservices covered, or exclude preventive care altogether.
In 2022, approximately $3.8 billion in preventive careservices were provided with no cost sharing for plan
enrollees, and $130 million in preventive care services
required some form of cost sharing for plan enrollees.
In 2022, approximately 47% of enrollees received
IPEE or AWV. This data point does not include annual
gynecological examinations.
HC-MC-260a.3—Number of customers receiving
care from Accountable Care Organizations or enrolled
in Patient-Centered Medical Home programs
The Cigna Collaborative Care program includes
accountable care organizations (ACOs) and is one of ourapproaches to achieving population health goals. Cigna
Healthcare launched its value-based care delivery morethan 10 years ago. Through coordinated and value-basedcare, ACOs provide better results, improve affordability
and efficiency, and deliver a better experience for patients.
Value-based care programs encompass approximately
240 accountable care programs. Through ourarrangements, we contract with over 126,000 primarycare providers and over 92,000 specialty providers.

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As a result of our focus, in 2022, the more than 3 million
U.S. commercial and Medicare Advantage customers invalue-based care arrangements received quality care ina timely manner. Plus, approximately 75% of our Medicare
Advantage customers are in value-based arrangements(as of December 2022).
In response to COVID-19, the flexibility of our programs
allowed us to make adjustments to ensure we maintained
the appropriate focus on high-risk individuals andpopulations with chronic conditions impacted by SDOH.
As we emerge from the pandemic, we are leveraging
new models to increase provider adoption of upside anddownside risk sharing to drive better health outcomes andlower the total cost of care.

Climate Change Impacts on Human Health
HC-MC-450a.1—Discussion of the strategy to address
the effects of climate change on business operations
and how specific risks presented by changes in thegeographic incidence, morbidity, and mortality ofillnesses and diseases are incorporated into risk models
2022 ESG Report, Climate Change and Emissions, page 49;
Sustainable Operations, page 52. Please also see our CDP
responses and our Independent Third-Party AssuranceStatement related to our reported GHG emissions
performance data.

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Activity MetricWorkforce Diversity and Engagement

HC-MC-000.A—Number of enrollees by plan type

SV-PS-330a.1—Percentage of gender and racial/ethnic
group representation for (1) executive managementand (2) all other employees

Cigna had approximately 18 million medical
customers within our Cigna Healthcare segment.
Reported data is segmented by funding types
and market segments. Refer to the following foradditional information: 2022 Fourth Quarter Financial
Supplement (“Total Medical Customers”), page 7, and2022 Form 10-K Filing, page 70.

2022 ESG Report, Performance Tables, page 69
SV-PS-330a.2—(1) Voluntary and (2) involuntary
turnover rate for employees
Our 2022 voluntary turnover rate was approximately 16%,and our involuntary turnover rate was approximately 3%.

SV-PS Professional andCommercial Services

SV-PS-330a.3—Employee engagement as a percentage

Data Security

Professional Integrity

SV-PS-230a.1—Description of approach toidentifying and addressing data security risks

SV-PS-510a.1—Description of approach to ensuring
professional integrity

2022 ESG Report, Data Protection, page 61

2022 ESG Report, Business Ethics and Compliance, page 58

2022 ESG Report, Human Capital Development, page 45

SV-PS-230a.2—Description of policies and practices
relating to collection, usage, and retention ofcustomer information
2022 ESG Report, Data Protection, page 61
SV-PS-230a.3—(1) Number of data breaches,(2) percentage involving customers’ confidential
business information (CBI) or personally identifiable
information (PII), (3) number of customers affected
See SASB disclosure HC-MC-230a.2 on page 74

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GRIStatement of use: The Cigna Group has reported in accordance with the GRI Standards for the period January 1, 2022, to December 31, 2022.
GRI 1 used: GRI 1: Foundation 2021

GRI 2: General Disclosures 2021
Disclosure2022 Reference

The Organization and Its Reporting Practices
2-1

Organizational details

The Cigna Group (The Cigna Group changed its name from Cigna Corporation on February 13, 2023.)

2-2 	Entities included in the organization’s sustainability reporting

2022 Form 10-K, Exhibit 21 - Subsidiaries of the Registrant (This is not a comprehensive list as this is a list of our significant
subsidiaries, as defined by SEC guidance.)

2-3

Reporting period, frequency and contact point2022 ESG Report, About This Report, page 4

2-4

Restatements of information

Restatements due to methodology changes are stated as footnotes throughout this ESG Report.

2-5

External assurance

2022 ESG Report, page 97. We received external assurance for Scope 1 and 2 GHG emissions, our energy consumption,and our water withdrawals. Assured data is denoted by bold typeface.

Activities and Workers
2-6

Activities, value chain and other business relationships

2022 Form 10-K, Item 1: Business, page 1

2-7

Employees2022 ESG Report, Performance Tables, page 70; Table 1, page 86. Approximately 1% of our employees have non-guaranteed hours.

Workers who are not employees

As of December 31, 2022, The Cigna Group engages approximately 49,000 nonemployee workers globally on a contract basis
as the consumer of services. Of those, approximately 5% are temporary workers supporting technology and general staffing
functions. Temporary workers are a classification of our nonemployee workers who are engaged through a third party
on an hourly time and materials basis under a shared direction and control model. All other categories of nonemployees
at The Cigna Group perform a broad variety of advisory, operational, technology, and administrative support functions on astatement of work and/or managed service contract basis.

2-8

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Disclosure

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

2022 Reference

Governance
2-9

Governance structure and composition

2022 ESG Report, Board Composition, page 56; 2023 Proxy Statement, Corporate Governance Policies and Practices, page 29;
Corporate Governance Committee Charter2-10 	Nomination and selection of the highest
governance body2023 Proxy Statement, Nomination Process, page 15; Board Corporate Governance Guidelines

2-11 Chair of the highest governance body2022 ESG Report, Board Composition, page 56; 2023 Proxy Statement, Board Leadership Structure, page 30

2-12 	Role of the highest governance body in overseeing
the management of impacts

2022 ESG Report, ESG Governance and Oversight, page 10; 2023 Proxy Statement, Responsibilities of the Board, page 34

2-13 Delegation of responsibility for managing impacts

2022 ESG Report, ESG Governance and Oversight, page 10; 2023 Proxy Statement, Responsibilities of the Board, page 34

2-14 	Role of the highest governance bodyin sustainability reporting

2022 ESG Report, ESG Governance and Oversight, page 10; 2023 Proxy Statement, Responsibilities of the Board, page 34

2-15 Conflicts of interest

2023 Proxy Statement, Director Independence, page 29

2-16 Communication of critical concerns

2023 Proxy Statement, Questions and Answers About the Annual Meeting and Voting, page 116

2-17 	Collective knowledge of the highest
governance body

ESG is discussed at least annually with the Board. In addition to annual ESG updates, specific ESG topics including
diversity, equity, and inclusion; cybersecurity; and human capital development are discussed quarterly.

2-18 	Evaluation of the performance of the highest
governance body

Board Corporate Governance Guidelines, Corporate Governance Committee Charter
ESG is included as a topic on the Board’s Evaluation Framework, which asks if the overall performanceand functioning of the Board is effective.

2-19 Remuneration policies

2023 Proxy Statement, Executive Compensation Policies and Practices, page 56

2-20 Process to determine remuneration

2023 Proxy Statement, Processes and Procedures for Determining Executive Compensation, page 55

2-21 Annual total compensation ratio

2023 Proxy Statement, Pay Ratio, page 90

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Disclosure

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

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2022 Reference

Strategy, Policies, and Practices
2-22 Statement on sustainable development strategy

2022 ESG Report, A Message from Leadership, page 5

2-23 Policy commitments

The Cigna Group is a signatory to the United Nations Global Compact. The Cigna Group is also a signatory to thepledge for CEO Action for Diversity & Inclusion and supports the Paradigm for Parity and the United Nations’
Women’s Empowerment Principles.

2-24 Embedding policy commitments

2022 ESG Report, Diversity, Equity, and Inclusion within Our Workforce, page 40; UN Global Compact, page 93

2-25 Processes to remediate negative impacts

Code of Ethics and Principles of Conduct

2-26 Mechanisms for seeking advice and raising concerns

Code of Ethics and Principles of Conduct, Supplier Code of Ethics, Anti-Corruption Policy

2-27 Compliance with laws and regulations

2022 Form 10-K, Note 23 – Contingencies and Other Matters (Legal and Regulatory Matters), page 133;
EthicsPoint (Ethics-Based Web Reporting)

2-28 Membership associations

2022 Political Contributions and Lobbying Activity Report

Stakeholder Engagement
2-29 Approach to stakeholder engagement

2022 ESG Report, page 86

2-30 Collective bargaining agreements

Approximately 1% of our employees are covered under collective bargaining agreements.

3-1

Process to determine material topics

2022 ESG Report, Our ESG Vision, Framework, and Strategy, page 9

3-2

List of material topics

2022 ESG Report, Our ESG Vision, Framework, and Strategy, page 9

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GRI 3: Material Topics 2021
Disclosure2022 Reference

Climate Change and Emissions
3-3 		

Management of material topics

2022 ESG Report, Climate Change and Emissions, page 49

201-2 	Financial implications and other risks and opportunities
due to climate change

CDP Climate Change, C2: Risks and Opportunities

302-1

Energy consumption within the organization

2022 ESG Report, Performance Tables, page 72; CDP Climate Change, C8: Energy

302-2

Energy consumption outside of the organization

Information unavailable/incomplete. As we complete our Scope 3 emissions analysis, we will explore and look to report
our energy consumption outside the organization in future reporting cycles.

302-3

Energy intensity

2022 ESG Report, Performance Tables, page 72

302-4

Reduction of energy consumption

CDP Climate Change, C4: Targets and Performance302-5 	Reductions in energy requirements of products
and services

Partially disclosed; 2022 ESG Report, Our GHG Footprint, page 50; Reducing Waste and Sourcing Responsibly, page 53

305-1

Direct (Scope 1) GHG emissions

2022 ESG Report, Performance Tables, page 71

305-2

Energy indirect (Scope 2) GHG emissions

2022 ESG Report, Performance Tables, page 71

305-3

Other indirect (Scope 3) GHG emissions

2022 ESG Report, Performance Tables, page 71

305-4

GHG emissions intensity

2022 ESG Report, Performance Tables, page 71

305-5

Reduction of GHG emissions

2022 ESG Report, Our GHG Footprint, page 50; CDP Climate Change, C7: Emissions Breakdowns

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Disclosure

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

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2022 Reference

Sustainable Operations
3-3 		

Management of material topics

2022 ESG Report, Sustainable Operations, page 52

303-1

Interactions with water as a shared resource

CDP Water Security, W1: Current State

303-2

Management of water discharge-related impacts

CDP Water Security, W1: Current State; W6: Governance

303-3

Water withdrawal

2022 ESG Report, Performance Tables, page 72; CDP Water Security, W1: Current State

303-4

Water discharge

CDP Water Security, W1: Current State

303-5

Water consumption

CDP Water Security, W1: Current State

306-1

Waste generation and significant waste-related impacts

2022 ESG Report, Reducing Waste and Sourcing Responsibly, page 53

306-2

Management of significant waste-related impacts

2022 ESG Report, Reducing Waste and Sourcing Responsibly, page 53

306-3

Waste generated

Information unavailable/incomplete. We’re currently evaluating the most appropriate methodology to use to capture
our waste data and create a baseline for our waste target.

306-4

Waste diverted from disposal

See GRI 306-3

306-5

Waste directed to disposal

See GRI 306-3

Sustainable Health Care
3-3 		

Management of material topics

2022 ESG Report, Sustainable Health Care, page 13

Product Service and Quality
3-3 		

Management of material topics

2022 ESG Report, Product Service and Quality, page 21416-1 	Assessment of the health and safety impacts
of product and service categories

2022 ESG Report, Product Service and Quality, page 21; Commitment to Quality

417-1 	Requirements for product and service informationand labeling2022 Form 10-K, Item 1: Business (Regulation), page 21

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Disclosure

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

2022 Reference

Health Equity
3-3 		

Management of material topics

2022 ESG Report, Health Equity, page 24

203-2

Significant indirect economic impacts

2022 ESG Report, Health Equity, page 24

Community Resilience3-3 		

Management of material topics

2022 ESG Report, Community Resilience, page 29

203-2

Significant indirect economic impacts

2022 ESG Report, Community Resilience, page 29413-1 	Operations with local community engagement,
impact assessments, and development programs

The Cigna Group engages with the communities we have a presence in through charitable efforts and other ways. See 2022
ESG Report, Community Resilience, page 29. The Cigna Group leaders often serve on local chambers of commerce and otherrelated organizations. While portfolio changes are an inherent part of a growing business, employees in communities that haveexperienced change have largely remained in the same geographies and transitioned to remote working. When we close a site,
our philosophy is to leave it better than we found it. We are transparent in all our disclosures to the new occupant/owner andcomplete all required due diligence before turning the site over.

413-2 	Operations with significant actual and potential
negative impacts on local communities

The Cigna Group does not believe it has any operations with a significant actual or potential negative impact
on local communities.

Employee Health, Safety, and Vitality
3-3 		

Management of material topics

2022 ESG Report, Employee Health, Safety, and Vitality, pages 35 and 38

401-2 	Benefits provided to full-time employees that are
not provided to temporary or part-time employees

The breadth and depth of our benefit programs have something for all employees. Medical benefits are accessible to thoseenrolled in the Cigna Healthcare Medical Plan, which includes the majority of our U.S. employee population, and we provide afull range of well-being resources to all U.S. employees. We expanded eligibility for the Cigna Healthcare Medical Plan in 2023
to offer access to affordable coverage for all of our U.S. employees—including non-guaranteed-hours employees.

401-3

Parental leave

Partially disclosed; all employees are entitled to caregiver leave, which includes time to care for a child.
Length varies by country. See also, 2022 ESG Report, Health and Vitality, page 36.

403-1

Occupational health and safety management system

2022 ESG Report, Occupational Health and Safety, page 38

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Disclosure

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

2022 Reference
The Hazard Hunt is one method used to identify and assess workplace hazards at The Cigna Group. It is intended to develop
safer employees and reduce workplace injuries by finding and fixing hazards. Hazard Hunts are routinely conducted at ouroperational sites and may involve site leadership, Safety Committee members, supervisors, leads, and employees. Hazard Hunts
are designed to be flexible based on the number of people involved in the inspection, time allotted for the inspection, numberof areas observed, and number of sections addressed.

403-2 	Hazard identification, risk assessment,
and incident investigation

Risk assessment processes involve collaboration both internally and externally with stakeholders on projects, processchanges, machinery, and equipment and other safety initiatives to reduce the risk of injury and illness and facilitate complianceby integrating decisions affecting occupational health and safety in the design process.
Work-related accidents, injuries, and illnesses are investigated to identify and ensure that corrective actions are taken
to prevent reoccurrence.
Employees are informed of how they are to report a work-related injury or illness with all information also available on our
intranet. Our Safety in the Workplace training provides the basic procedures for reporting, emphasizes the importance ofreporting, and informs employees that they have a right to report work-related injuries and illnesses free from discharge,
discrimination, or retaliation.

403-3

Occupational health services

Immediate and timely reporting helps to ensure injured or ill employees receive prompt medical treatment when needed, is anecessary component of the workers’ compensation process, and aids in the incident investigation process. Occupational healthservices are managed by our workers’ compensation claims administrator, who provides clinical consultation via a 24/7 nurse
triage line, provides medical assessment and care recommendations, and helps set up workers’ compensation claims.
Additionally, qualified third-party providers are engaged to assist with managing other occupational health and safety
programs, such as respiratory protection program services and others.

403-4 	Worker participation, consultation, and communication
on occupational health and safety2022 ESG Report, Occupational Health and Safety, page 38

403-5

Worker training on occupational health and safety2022 ESG Report, Occupational Health and Safety, page 38

403-6

Promotion of worker health2022 ESG Report, Health and Vitality, page 36

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Disclosure2022 Reference

403-7 	Prevention and mitigation of occupational
health and safety impacts directly linked
by business relationships

It is the policy of The Cigna Group to establish minimum safety performance standards that must be observed byand complied with by all contractors in order to minimize the potential of injury or damage to contractor employees,
The Cigna Group employees, facilities, equipment, and products. Contractors while working on properties or facilities owned
or managed by The Cigna Group are expected to work in a safe and compliant manner. All contractors are required to adhere
to all applicable local, state, and federal health, safety, and environmental laws and regulations.

403-8 	Workers covered by an occupational healthand safety management system

2022 ESG Report, Occupational Health and Safety, page 38403-92022 ESG Report, Performance Tables, page 69

Work-related injuries

403-10 Work-related ill health

The Cigna Group does not distinguish between work-related injuries and ill health in its safety incident rate.

Diversity, Equity and Inclusion within Our Workforce
3-3 		

Management of material topics

2022 ESG Report, Diversity, Equity, and Inclusion within Our Workforce, page 40

405-1

Diversity of governance bodies and employees

2022 ESG Report, Performance Tables, page 69

405-2 	Ratio of basic salary and remunerationof women to men

2022 ESG Report, Fair Pay, page 42406-1 	Incidents of discrimination and corrective
actions taken

Complaints of discrimination are formally investigated and handled appropriately. Number, status of incidents, and actions
taken are not reported as this information is considered confidential.

Human Capital Development
3-3 		

Management of material topics

2022 ESG Report, Human Capital Development, page 44
2022 ESG Report, Performance Tables, page 71

401-1

New employee hires and employee turnover

402-1

Minimum notice periods regarding operational changes

The Cigna Group complies with all federal, state, and local legal and regulatory requirements in the states and countries
we operate, including providing appropriate notice to employees who are impacted by business and/or operational changes.

404-1

Average hours of training per year per employee

2022 ESG Report, Performance Tables, page 71

Our 2022 voluntary turnover rate was approximately 16%, and our involuntary turnover rate was approximately 3%.

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Disclosure2022 Reference404-2 	Programs for upgrading employee skills and transition
assistance programs2022 ESG Report, Training and Development, page 46

404-3 	Percentage of employees receiving regularperformance and career development reviews

Partially disclosed; 2022 ESG Report, Enabling Performance Growth and Development, page 47

ESG PERFORMANCE METRICS

Leadership and Accountability
3-3 		

Management of material topics

2022 ESG Report, Leadership and Accountability, page 56

415-1

Political contributions

2022 Political Contributions and Lobbying Activity Report

Business Ethics and Compliance3-3 		

Management of material topics

2022 ESG Report, Business Ethics and Compliance, page 58

205-1

Operations assessed for risks related to corruption

The Cigna Group plans to disclose this during our 2023 reporting cycle.

205-2 	Communication and training about anti-corruption
policies and procedures

2022 ESG Report, Anti-Bribery and Corruption, page 59

205-3

Any material noncompliance matters are disclosed in the company’s public reports filed with the Securities
and Exchange Commission.

Confirmed incidents of corruption and actions taken

206 	Legal actions for anti-competitive behavior,anti-trust, and monopoly practices

Any material noncompliance matters are disclosed in the company’s public reports filed with the Securities
and Exchange Commission.

416-2 	Incidents of non-compliance concerning the healthand safety impacts of products and services

Any material noncompliance matters are disclosed in the company’s public reports filed with the Securities
and Exchange Commission.

417-2

Any material noncompliance matters are disclosed in the company’s public reports filed with the Securities
and Exchange Commission.

I ncidents of non-compliance concerning productand service information and labeling417-3 	Incidents of non-compliance concerning marketing
communications

Any material noncompliance matters are disclosed in the company’s public reports filed with the Securities
and Exchange Commission.

419-1 	Non-compliance with laws and regulations in the socialand economic area

Any material noncompliance matters are disclosed in the company’s public reports filed with the Securities
and Exchange Commission.
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Disclosure

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

2022 Reference

Data Protection
3-3 		

Management of material topics

418-1 	Substantiated complaints concerning breachesof customer privacy and losses of customer data

2022 ESG Report, Data Protection, page 61
The Cigna Group is committed to protecting the confidentiality of member information. The Privacy Office ensures
all potential privacy incidents are thoroughly researched and investigated. If an issue is determined to be substantiated,
the Privacy Office ensures that the appropriate corrective actions are taken to prevent future occurrences and that steps
are taken to mitigate any harm to the extent possible. In addition, depending on the nature of the incident, notifications
may be sent to the client, member, or regulatory authorities, including to the U.S. Department of Health and Human
Services Office for Civil Rights. As with all large health care organizations, such incidents do occur; however, the majorityof such incidents impact just one individual.

Responsible Supply Chain
3-3 		

Management of material topics

2022 ESG Report, Responsible Supply Chain, page 65

203-2

Significant indirect economic impacts

2022 ESG Report, Responsible Supply Chain, page 67

204-1

Proportion of spending on local suppliersOver 98% of our indirect spend in the United States is from suppliers based in the United States.

308-1 	New suppliers that were screened using
environmental criteria

2022 ESG Report, Supplier Governance and Risk, page 65

308-2 	Negative environmental impacts in the supply chain
and actions taken

Partially disclosed; 2022 ESG Report, Supplier Governance and Risk, page 65

412-3 	Significant investment agreements and contracts
that include human rights clauses or that underwent
human rights screening

Human rights and compliance with local laws and regulations are emphasized in our Supplier Code of Ethics, which isreferenced in our vendor agreements and contracts. Potential vendors must read and attest that they comply with our
Supplier Code of Ethics and that attestation is standard in all our indirect supplier contracts.

414-1

2022 ESG Report, 2022 ESG Report, Supplier Governance and Risk, page 65

New suppliers that were screened using social criteria414-2 	Negative social impacts in the supply chain
and actions taken

Partially disclosed; 2022 ESG Report, Supplier Governance and Risk, page 65

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Table 1: GRI 2-7 Employees

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS(global workforce as of December 31, 2022)

GRI 2-29 Approach to stakeholder
engagement

Employee Type

Clients (Employer clients and health plans)

Employees• Health and wellness programs• Employee insights surveys• Health engagement incentive programs• Quarterly town hall meetings hosted by our CEO
and other senior leaders

Female

Male

Total

Full-time employees

69%

28%

97%

Part-time employees

2%

1%

3%

Total

71%

29%

100%

• Client forums on meaningful business and healthcare topics• Annual Report, Proxy Statement, and ESG Report

Employee Type

UnitedStatesInternational

Total

Community partners, neighbors, andnon-governmental organizations (NGOs)

Full-time employees

91%

6%

97%

• In-person meetings, calls, and conference calls

Part-time employees

3%Less than 1%

3%• Social media

100%• Events with local leaders, neighbors, NGOs, andadvocacy groups

Total

94%

6%

• Our employee dispute resolution program, Be HEARD• Performance management and development programs• Annual Report, Proxy Statement, and ESG Report• Company intranet, email• In-person meetings• 24/7 Ethics Help Line• ERGs• Matching gift program• Board memberships• Recognition programs• Financial support (grants and corporate contributions)

Health care professionals• Employee volunteering• 24/7 Veteran Support Line (available to veterans andtheir families regardless of whether they are customers)• Annual Report, Proxy Statement, and ESG Report• In-person meetings, calls, and conference calls• Conferences and convenings• Quarterly newsletters• Annual Report, Proxy Statement, and ESG Report20 2 2 E NVI R O N M E N TA L , S O C I A L , A N D G OVE R N A N C E R E P O RT

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GRI 2-29 Approach to stakeholder
engagement (continued)
Health plan customers and patients• Cigna One Guide® service, which provides personalized
concierge services and increases the ease with whichcustomers can connect with and use their health plan benefits• 24/7 customer service call centers• Health Information Line with access to clinicians,
nutritionists, educators, and health care specialists• In-person conversations• Social media• Annual Report, Proxy Statement, and ESG Report• myCigna and the myCigna App, which allow
customers to find the cost of care, view claims, manage
spending accounts, and receive plan notifications• Disaster Resource Center• Customer satisfaction surveys, customer focus groups,
and Net Promoter Scores

Investors• Annual Report, Proxy Statement, and ESG Report• Press releases• Investor Relations website

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T• One-on-one meetings to discuss financial performanceand ESG issues• Annual Meeting of Shareholders and Investor Day• Reporting to ESG ratings firms, such as CDP Water
and Climate, S&P Global DJSI/CSA, and EcoVadis

National and local government officials(United States and abroad)• In-person meetings, calls, and conference calls• Conferences and convenings• Industry association participation and public policy forums• Press conferences• Participation in government councils and committees• Transparency regarding political contributions• Annual Report, Proxy Statement, and ESG ReportNews media• Press releases• Social media• Primary market research• Desk-side briefings• Annual Report, Proxy Statement, and ESG Report• Newsroom

H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS

Suppliers, vendors, and business partners• 24/7 Ethics Help Line• In-person meetings, calls, and conference calls• Conferences and workshops• Supplier/vendor registration form and related websites• Supplier Code of Ethics• Annual Report, Proxy Statement, and ESG Report

Thought leaders and advocatesin issue areas related to health services• Board memberships• In-person and virtual meetings, calls, and conference calls• Conferences and convenings• Industry groups, roundtables, workshops, and events• Joint projects• Annual Report, Proxy Statement, and ESG Report

U.S. state, U.S. federal, andinternational regulators• In-person meetings, calls, and conference calls• Conferences and convenings• Annual Report, Proxy Statement, and ESG Report• Webcasts and conference calls• Health care investor conferences, office visits, androad shows—virtually and in person as appropriate

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TCFDThe Cigna Group also reports to CDP Climate Change and Water Security. Our latest submissions are available here.

Governance

Strategy(a) Describe the board’s oversightof climate-related risks and opportunities.

Short-term: We typically consider the 1–3 year time horizon
when establishing short-term objectives and monitoringnear-term climate-related risks and opportunities.

The highest level of responsibility within The Cigna Groupfor the management of climate-related issues is held by the
Corporate Governance Committee of our Board of Directors.
Specific responsibilities of the Corporate GovernanceCommittee include oversight of the ESG framework
and related sustainability policies, practices, and initiatives.
The Corporate Governance Committee monitors thecompany’s social responsibility and environmental
sustainability policies, practices, and initiatives; reviews
the annual ESG report; and periodically updates andmakes recommendations to the Board with respect
to such matters.
Within The Cigna Group Board of Directors, the Audit
Committee also maintains oversight over enterprise risks,
including but not limited to those related to climate change.
References: Environmental Policy Statement,
Corporate Governance Committee Charter,
2023 Proxy Statement
Relevant CDP Section(s): C1.1 , C1.1b(b) Describe management’s role inassessing and managing climate-relatedrisks and opportunities.
The ESG Advisory Committee comprises several
senior leaders from across the company to support
Our ongoing commitment to environmental stewardship,a sustainable and equitable health care system, employees,
corporate social responsibility, corporate governance, andsustainability. Ultimately, this Committee, with support
from our Risk Management and ESG teams, seeks to further
integrate into and align sustainability with our enterprisestrategy and operations.
Our Corporate Real Estate Managing Director oversees
our facilities-related environmental sustainability strategy
and initiatives, manages the Corporate Real Estate
Senior Director responsible for oversight of energy andemissions targets and reduction activities, and oversees
our Environmental Policy Statement. Our Corporate Real
Estate Managing Director reports directly to the Senior Vice
President of Service Operations.

Medium-term: We typically consider the 4–6 year time
horizon when establishing medium-term objectives
and monitoring associated climate-related risks andopportunities that are not imminent in the short-term
but are pertinent around the 5-year term.
Long-term: We typically consider the 7–10 year time horizon
when establishing long-term objectives and monitoring
associated climate-related risks and opportunities withina long-term time horizon. (While using a 7–10 year time
horizon, we also try to look ahead toward economic, social,and environmental trends over the next few decades that
may affect our company and the health care industry.)

References: Climate Change and Emissions,
Environmental Policy Statement
Relevant CDP Section(s): C1.2, C1.2a
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H E A LT H Y C O M P A N Y

ESG PERFORMANCE METRICS(a) Describe the climate-related risks andopportunities the organization has identified
over the short, medium, and long term.
Opportunities:a) Medium term (Resource efficiency): Our Global Real
Estate team is guided by our Strategic Sustainability
Performance Plan and our environmental targets.
We set a target to reduce our Scope 1 and 2 emissions
by 50% by 2030 from 2019 baseline. Additionally, we
set targets to become carbon neutral for Scope 1 and2 emissions by 2040 and to achieve 100% renewableelectricity purchased by 2030 as part of our RE100
commitment. Increasing the energy efficiency ofbuildings in our real estate portfolio presents theopportunity to reduce our operating costs from energy
consumption and reduce emissions generated fromour buildings, thereby helping us achieve our climate
goals. Our global real estate portfolio has a footprintof 9.8 million square feet, of which approximately
9 million square feet are part of our Scope 1 and 2
emissions initiatives. A commitment to energy-efficient
operations is consistent with The Cigna Group corporate
values, which include caring deeply, acting with purpose,and creating a better future together.
Risks:a) S hort term (Physical/Acute): The Cigna Group, as a
global health organization, has operations and facilities
in geographical areas that are subject to natural
hazards and extreme weather events. In a high-carbon
scenario where the global temperature reaches above

2°C, the frequency, length, and severity of hurricanes
will likely be exacerbated and could impact ourbusiness services, affect distribution capacities, andhave potential to cause damage to physical assets in
our high-risk locations. Over the past four years, The
Cigna Group has experienced approximately $1.5M
in direct physical and business operation loss costs
related to natural disaster events in these high-risk
locations. The Cigna Group completes an annual due
diligence review of its operations by partnering with our
insurance brokers and internal subject matter experts
to evaluate the exposures of our key locations, risk
tolerance, industry benchmarking data, and historicalloss trends, plus an assessment of coverages available in
the insurance marketplace to ensure the most effective
risk financing solutions are implemented. Additionally,
these risks are mitigated and managed through ourBusiness Continuity and Global Risk Management
teams, which have built out processes to prepare ouroperations in the wake of business disruptions. We also
understand that climate change and environmental
acute physical risks may pose unique challenges toclients and communities—specifically health and publichealth systems. In the event of extreme hurricanes
and flooding disasters, the execution of our Customer
Disaster Response Program may result in making
temporary policy changes, such as waiving various
medical requirements, assisting with replacement

medications, transferring prescriptions, andexpanding its help line to proactively address
customer service issues and provide personal
assistance and support for all affected by a disaster.
b) Medium term (Transition/Market): Uncertainty in theprice of energy and fuel could continue to increase
our direct and indirect operating costs. It is expectedthat electricity rates will rise as utilities and regulators
make improvements to the electricity grid to increase
resiliency against climate-related weather events and as
broad electrification increases to reduce GHG emissions.
Additionally, we consider geopolitical impacts on theprice of fuel and how the use of transportation in ouroperations will be impacted by rising prices of fuel.
Due to the rising economic prices of oil and gas globallyin recent years, this risk has been identified as having amoderate to very high probability of occurrence. In 2022,
our total utility spend was approximately $22 million,
which is anticipated to increase based on current
market trends. Through internal forecasted analysis,
we anticipate that utility grid improvements andupgrades could potentially pose a substantive impact
on our electricity bills in the medium-term timeframedue to the prolonged time it will take for utilities andregulators to make such transformative changes.
Relevant CDP Section(s): C2.1a, C2.3, C2.3a, C2.4, C2.4a

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ESG PERFORMANCE METRICS(b) Describe the impact of climate-relatedrisks and opportunities on the organization’s
businesses, strategy, and financial planning.
Impact on Businesses and Strategy
Potential risks associated with product and services(including The Cigna Group health care plans andpharmacy benefits management services) include
extreme weather events and shifts in consumer
preferences. Upstream potential risks associated with
our supply chain include changes in the cost of energy,
fuel, and commodities in addition to broader uncertainty
in market signals associated with climate change.
Downstream potential risks within The Cigna Group value
chain (our health services customers and the key markets
we serve) include those associated with extreme weather
events and correlations between chronic climate changerisks and human health. The management of these risks
may also present the opportunity for The Cigna Group to
increase long-term profitability and establish competitive
advantages.
Potential risks associated with operations (including ourglobal real estate portfolio) include potential increases
in the price of energy and fuel. Potential opportunities
include moving to more energy-efficient buildings andparticipating in renewable energy programs.
These risks have been integrated into our businessstrategy and planning process through (1) our establishingof new third-generation environmental targets and(2) our investments to maintain and continue to enhance
our Disaster Response, Employee Assistance, BusinessContinuity, and Data Center Recovery Programs.

The management of risks also presents the opportunity
for The Cigna Group to increase operational efficiency andestablish competitive advantages. The potential magnitudeof these risks and opportunities is currently considered
to be low (in the context of our current pre-tax adjusted
income from operations and net income) and difficult toaccurately forecast over the next 1 to 10 years.
Impact on Financial Planning
The most significant risk identified as having a potential
impact to our revenues is related to reputation, as corporate
employer clients are increasingly interested in climatechange and broader ESG performance. The managementof these risks also presents the potential opportunity toincrease revenue through competitive differentiation. The
most significant risk identified as having a potential impact
to our operating costs is changes in the cost of energy,
fuel, and commodities. Potential opportunities associatedwith managing this risk include the move to more energyefficient buildings and participating in renewable energy
programs. The most significant risks identified as having
a potential impact to our capital expenditures are (1) theneed to mitigate risks associated with increases in thecost of energy, fuel, and commodities and (2) the needto reduce our operational footprint from a reputational
perspective and work to meet our environmental targets.
Potential opportunities associated with managing this risk
include the move to more energy-efficient buildings andparticipating in renewable energy programs.

These risks have been integrated into our businessstrategy and planning processes.
References: Climate Change and Emissions,
Environmental Policy Statement
Relevant CDP Section(s): C2.3a, C2.4a, C3.1, C3.2a, C3.2b,C3.3, C3.4(c) Describe the resilience of theorganization’s strategy, taking into
consideration different climate-related
scenarios, including a 2°C or lower scenario.
The findings from qualitative and quantitative scenario
analyses related to climate change informed our strategy
and approach to managing climate-related risks andopportunities through our (1) establishment of our targets
toward carbon neutrality for Scope 1 and 2 emissions by
2040, (2) identification of emissions reduction projects
to support our interim 2030 targets, (3) pursuit of LEED
certification and ENERGY STAR building ratings, and (4)investments in renewable electricity consumption.
References: Climate Change and Emissions,
Environmental Policy Statement
Relevant CDP Section(s): C3.2, C3.2a, C3.2b

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Risk Management(a) Describe the organization’s processes for
identifying and assessing climate-related risks.

(b) Describe the organization’s processes
for managing climate-related risks.

Company-Level Process Overview

The Cigna Group responds to climate-related risks andopportunities through a decision-making process withrespect to mitigation, transfer, acceptance, and/or control
of potential climate change risks and opportunities,
which considers the degree of potential regulatory,
physical, and other business impacts to The Cigna Groupidentified through the assessment stage. We consider all
geographic locations and markets where we operate, in
addition to potential new markets, during the evaluation.
The company’s BC team sets forth plans and proceduresfor the continuation of business functions and the useof supporting technology to recover critical businessprocesses in the event of hurricanes, wildfires, and otherunexpected disruptions, including pandemics. The plansand procedures are updated and documented annually,
and the enterprise-wide recovery strategies are conducted
on an annual basis. Our Global Real Estate team has aformal process for proposing, evaluating, and budgetingfor consumption reduction projects that serve asopportunities to improve the efficiency of our operations
and support our environmental sustainability targets.

The Cigna Group uses both bottom-up and topdown approaches to identify climate-related risks andopportunities within the company. The ESG and BusinessContinuity (BC) teams maintain regular identificationand oversight of any company-level risks (i.e., acute andchronic physical risks) related to climate change that may
impact our physical assets, reputation, profitability, andaccess to capital. Cross-functional perspectives from the
ESG Advisory Committee provide additional assistancein the identification of company-wide market risks andopportunities related to climate change.
Asset-Level Process Overview
At the asset level, the Global Real Estate Sustainability
Manager oversees our Inventory Management Program
to identify additional climate-related risks and opportunities
with the support of the ESG Lead.
References: Climate Change and Emissions,
Environmental Policy Statement
Relevant CDP Section(s): C2.1, C2.1a, C2.2, C2.2a(c) Describe how processes for identifying,assessing, and managing climate-relatedrisks are integrated into the organization’s
overall risk management.
Our Risk Management team also facilitates a formal
annual review process for business stakeholders to identify
physical, regulatory, and business risks which include, but
are not limited to, energy and natural resource pricing,supply chain, and business continuity risks. Environmental
risk, including risk drivers associated with climate change,
is an explicit risk within our enterprise risk register.
Within The Cigna Group Board of Directors, the Audit
Committee also maintains oversight over enterpriserisks, including, but not limited to, those related toclimate change.
References: Climate Change and Emissions,
Environmental Policy Statement
Relevant CDP Section(s): C2.1, C2.2

References: Climate Change and Emissions,
Environmental Policy Statement
Relevant CDP Section(s): C2.1, C2.2

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H E A LT H Y W O R K F O R C E

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Metrics and Targets		
(a) Disclose the metrics used by theorganization to assess climate-related risks
and opportunities in line with its strategy
and risk management process.

(b) Disclose Scope 1, Scope 2, and,if appropriate, Scope 3 GHG emissions,and the related risks.

The Cigna Group monitors and reports on our Scope 1 and 2
emissions and our Scope 3 (business travel) GHG emissions.
We also monitor and report on indirect and direct energy
consumption, including renewable energy and energy
intensity metrics. We also track and report on green
building certifications and ratings throughout our global
real estate portfolio.

• Scope 2 (location-based): 86,858 mtCO2e

References: Climate Change and Emissions,
Assurance Statement		

• Scope 1: 14,566 mtCO2e• Scope 2 (market-based): 59,664 mtCO2e• Scope 3 (business travel): 10,535 mtCO2e(68)(c) Describe the targets used by theorganization to manage climate-relatedrisks and opportunities and performanceagainst targets.
We set the following climate-related targets to drive
progress on operational sustainability:• Reduce Scope 1 and 2 GHG emissions by 50%
by 2030 from 2019 baseline.

Please see page 71 for applicable footnotes.

• Achieve carbon neutrality for Scope 1 and 2 GHG
emissions by 2040.

References: Climate Change and Emissions,
Assurance Statement					• Source renewable electricity for 100% of our global
power needs by 2030.

Relevant CDP Section(s): C6.1, C6.3, C6.5, C6.5a

Relevant CDP Section(s): C4.2, C4.2a, C4.2b, C9.1

The Cigna Group has not set any targets for Scope 3
emissions. Our current emissions targets are only
inclusive of Scope 1 and Scope 2 emissions.
References: Climate Change and Emissions,
Assurance Statement		Relevant CDP Section(s): C4.1, C4.1a, C4.1b, C4.2,
C4.2a, C4.2b

68 We updated our 2022 Scope 3 business travel emissions shortly after our original 2022 ESG Report publication on July 10, 2023. We adjusted the value to more accurately and consistently apply the UK’s Department for Environment, Food & Rural Affairs (DEFRA) methodology.

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H E A LT H Y W O R K F O R C E

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Human Rights
1

Businesses should support and respect the protectionof internationally proclaimed human rights.
• The Cigna Group Policies and Statements: Human Rights Statement,
Supplier Code of Ethics

UN Global
Compact
The Cigna Group was the first U.S. health service
company to sign on to the UN Global Compact
in 2015. As a signatory, we are committed
to living out the Compact’s 10 principles onhuman rights, labor standards, environment,
and anti-corruption (business integrity) in
our everyday business operations.

• 2022 Performance and Approach: Diversity, Equity, and Inclusion within
Our Workforce, Business Ethics and Compliance, Responsible Supply Chain

2

Businesses should make sure that they are not complicit
in human rights abuses.
• The Cigna Group Policies and Statements: Human Rights Statement• 2022 Performance and Approach: Diversity, Equity, and Inclusion within
Our Workforce, Business Ethics and Compliance, Responsible Supply Chain

Labor
3

Businesses should uphold the freedom of association andthe effective recognition of the right to collective bargaining.
• The Cigna Group Policies and Statements: Human Rights Statement• 2022 Performance and Approach: Business Ethics and Compliance,
Responsible Supply Chain

4

Businesses should uphold the elimination of all formsof forced and compulsory labor.
• The Cigna Group Policies and Statements: Human Rights Statement• 2022 Performance and Approach: Business Ethics and Compliance,
Responsible Supply Chain

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INTRODUCTION

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H E A LT H Y W O R K F O R C E

Businesses should uphold the effective abolition of child labor.
• The Cigna Group Policies and Statements: Human Rights Statement

H E A LT H Y E N V I R O N M E N T

9• 2022 Performance and Approach: Business Ethics and Compliance,
Responsible Supply Chain

Environment
7

Businesses should support a precautionary approachto environmental challenges.

Businesses should encourage the development
and diffusion of environmentally friendly technologies.
• 2022 Performance and Approach: Climate Change and Emissions,Sustainable Operations, CDP Climate Change, CDP Water Security

Businesses should uphold the elimination of discriminationin respect of employment and occupation.
• The Cigna Group Policies and Statements: Code of Ethics and Principles
of Conduct, Supplier Code of Ethics, Equal Employment Opportunity

ESG PERFORMANCE METRICS• The Cigna Group Policies and Statements: Environmental Policy Statement• 2022 Performance and Approach: Business Ethics and Compliance,
Responsible Supply Chain

6

H E A LT H Y C O M P A N Y

Anti-Corruption
10

 usinesses should work against corruption in all its forms,
B
including extortion and bribery.
• The Cigna Group Policies and Statements: Code of Ethics and Principles
of Conduct, Anti-Corruption Policy• 2022 Performance and Approach: Business Ethics and Compliance• The Cigna Group Policies and Statements: Environmental Policy Statement• 2022 Performance and Approach: Climate Change and Emissions,Sustainable Operations, CDP Climate Change, CDP Water Security

8

Businesses should undertake initiatives to promote
greater environmental responsibility.
• The Cigna Group Policies and Statements: Environmental Policy Statement• 2022 Performance and Approach: Climate Change and Emissions,Sustainable Operations, CDP Climate Change, CDP Water Security

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UN Sustainable
Development
Goals (SDGs)
We aim to align our activities with the 17 aspirational global
goals and 169 targets set forth in the UN SDGs, a blueprint
for governments, businesses, and civil society organizations
to address the most pressing environmental and social
issues globally.
Among all of the SDGs, the third goal of good healthand well-being provides the greatest opportunity for The
Cigna Group to contribute specific industry expertise andresources to drive meaningful progress. We are also focusedon opportunities to support other SDGs that are relevant toour business.

H E A LT H Y W O R K F O R C E

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SDG 2: Zero Hunger• Healthier Kids For Our Future• Community Resilience
The Cigna Group Foundation awarded a grant to Arogya World in India to educate
Indians on proper nutrition, portion control, and how to combat malnutrition througha user-friendly platform, social media, local celebrity influencers, and traditional media.

SDG 3: Good Health and Well-Being• Value of Integration Study• Health Equity• Sustainable Health Care
• Community Resilience• Evernorth Vitality Index
The Cigna Group Foundation awarded a grant to the South Asian Network, Inc., in Artesia,
California, to provide approximately 120 clients per year with a bilingual/bicultural mental
health therapist and create materials and training for religious and cultural leaders—the goal
being to advance the emotional and mental health of South Asians across Southern California.

SDG 4: Quality Education• Community Resilience
The Cigna Group Foundation awarded a grant to Leap Year in Atlanta, Georgia, anorganization that connects elementary school students with recent first-generationhigh school graduates to address literacy gaps.

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SDG 5: Gender Equality

SDG 10: Reduced Inequalities• Diversity, Equity, and Inclusion within Our Workforce• Health Equity• Pay Equity Commitment Statement• Community Resilience• Health Equity

The Cigna Group Foundation awarded a grant to the Universityof Maryland Center for Health Equity HAIR Program to further
expand their infrastructure to engage barbershops and salonsas culturally relevant portals for health education as well as thedelivery of public health services. See page 30 for additional details.

• United Nation’s Women’s Empowerment Principles• Paradigm for Parity• CEO Action for Diversity and InclusionTM• Community Resilience
The Cigna Group Foundation awarded a grant to the COMMIT
Foundation to help approximately 200 female service members
and military spouses thrive in their post-military lives. This includes
one-on-one transition support, executive coaching workshops,
housing, and improved access to mental health care.

SDG 12: Responsible Consumption
and Production• Sustainable Operations• Environmental Policy Statement

SDG 8: Decent Work and Economic
GrowthWe continue to empower our customers to reduce their environmental
impact by providing them with the option to receive paperlessstatements, submit claims online, and view plan information
through myCigna and the myCigna App.

• Human Rights Statement• Diversity, Equity, and Inclusion within Our Workforce• Business Ethics and Compliance

SDG 13: Climate Action• Supplier Code of Ethics• Climate Change and Emissions

We pair diverse suppliers with The Cigna Group executives throughour 18-month Cigna Supplier Mentor Protégé Program. Throughout
the 18 months, protégés have one-on-one monthly meetings with
their dedicated mentors and once each quarter protégés attend
onsite forums to learn about industry best practices from subject
matter experts. See page 66 for additional details.

• CDP Climate Change• Sustainable Operations• Environmental Policy Statement
We are progressing toward our RE100 goal of sourcing 100% renewableelectricity by 2030. We purchased RECs to address 100% of our electricity
usage at our primary data center in Connecticut, one of our most energy
intensive locations. Plus, 100% of the electricity at our colocation data centerin Piscataway, New Jersey, comes from renewable sources of energy.
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External
Assurance
LetterH E A LT H Y S O C I E T Y

H E A LT H Y W O R K F O R C E

H E A LT H Y E N V I R O N M E N T

Independent Limited Assurance Statement to Cigna Corporation
ERM Certification & Verification Services Incorporated (“ERM CVS”) was engaged by Cigna Corporation(“Cigna”) to provide limited assurance in relation to the selected information set out below andpresented in the 2022 Cigna Connects Corporate Responsibility Report, 2023 CDP Climate Change
Questionnaire and 2023 CDP Water Security Questionnaire (the “Reports”).
Engagement summary

Scope of our
assuranceengagement

Whether the 2022 information and data for the specified indicators listed below are fairly
presented in accordance with the reporting criteria:
GHG Emissions Indicators• Scope 1 greenhouse gas (GHG) emissions (MT CO2e)• Scope 2 greenhouse gas (GHG) emissions (location-based) (MT CO2e)• Scope 2 greenhouse gas (GHG) emissions (market-based) (MT CO2e)• Year on Year GHG Performance (2021 to 2022 Scope 1 greenhouse gas
emissions) (percent)• Year on Year GHG Performance (2021 to 2022 Scope 2 location-based
greenhouse gas emissions) (percent)• Performance towards GHG reduction target (2019 to 2022 Scope 1 and Scope 2
market-based greenhouse gas emissions) (percent)*
Energy Indicators• Energy consumption (kWh)• Energy consumption from renewable sources (percent)Water• Water withdrawal (kgal)* ERM CVS did not assure 2019 data and therefore places reliance on Cigna’s data aspresented in the 2019 Corporate Responsibility Report and CDP Climate Change
Questionnaire as the basis of the percentage change calculation.

Reporting period
Reportingcriteria

Assurance
standard andlevel ofassurance

Respective
responsibilities

The data covered by the assurance is the year January 1, 2022 - December 31, 2022.
••

WBCSD/WRI GHG Protocol (2004, as updated January 2015) for the Scope 1
and Scope 2 GHG emissions
Cigna’s internal reporting criteria and definitions

We performed a limited assurance engagement, in accordance with the International
Standard on Assurance Engagements ISAE 3000 (Revised) ‘Assurance Engagements
other than Audits or Reviews of Historical Financial Information’ and ISO 14064:3 forGreenhouse Gas data.
The procedures performed in a limited assurance engagement vary in nature and timing
from, and are less in extent than for a reasonable assurance engagement andconsequently, the level of assurance obtained in a limited assurance engagement issubstantially lower than the assurance that would have been obtained had a reasonableassurance engagement been performed.
Cigna is responsible for preparing the Reports and for the collection and presentation of
the information within it, and for the designing, implementing and maintaining of internal
controls relevant to the preparation and presentation of the Report/Selected Information.
ERM CVS’ responsibility is to provide conclusions to Cigna on the agreed scope basedon our engagement terms with Cigna, the assurance activities performed and exercising
our professional judgement. We accept no responsibility, and deny any liability, to any
party other than Cigna for the conclusions we have reached.

Our conclusion
Based on our activities, as described below, nothing has come to our attention to indicate that the 2022 dataand information for the disclosures listed under ‘Scope’ above are not fairly presented in the Reports, in allmaterial respects, in accordance with the reporting criteria.

H E A LT H Y C O M P A N Y

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Our assurance activities
Considering the level of assurance and our assessment of the risk of material misstatement of the Reports a
multi-disciplinary team of sustainability and assurance specialists performed a range of procedures that
included, but was not restricted to, the following:•

Assessing the appropriateness of the reporting criteria for the Selected information•

Interviews with management representatives responsible for managing the selected issues.

•

Interviews with relevant staff to understand and evaluate the relevant management systems andprocesses (including internal review and control processes) used for collecting and reporting theselected disclosures.

•

A review at corporate level of a sample of qualitative and quantitative evidence supporting the reported
information.

•

An analytical review of the year-end data submitted by all locations included in the consolidated 2022
group data for the selected disclosures which included testing the completeness and mathematicalaccuracy of conversions and calculations, and consolidation in line with the stated reporting boundary.

•Interviews with relevant staff and third parties to understand and evaluate the data management
systems and processes (including IT systems and internal review processes) used for collecting andreporting the selected data; checking the calculations and assessing the local internal quality assurance
processes.

•

Confirming conversion and emission factors and assumptions used.

•

Reviewing the presentation of information relevant to the scope of our work in the Reports to ensure
consistency with our findings.

The limitations of our engagement
The reliability of the assured information is subject to inherent uncertainties, given the available methods fordetermining, calculating or estimating the underlying information. It is important to understand our assurance
conclusions in this context.
Our independence, integrity and quality control
ERM CVS is an independent certification and verification body accredited by UKAS to ISO 17021:2015.
Accordingly we maintain a comprehensive system of quality control, including documented policies andprocedures regarding compliance with ethical requirements, professional standards, and applicable legal andregulatory requirements. Our quality management system is at least as demanding as the relevant sections of
ISQM-1 and ISQM-2 (2022).
ERM CVS applies a Code of Conduct and related policies to ensure that its employees maintain integrity,
objectivity, professional competence and high ethical standards in their work. Our processes are designed andimplemented to ensure that the work we undertake is objective, impartial and free from bias and conflict ofinterest. Our certified management system covers independence and ethical requirements that are at least as
demanding as the relevant sections of Parts A & B of the IESBA Code relating to assurance engagements.
The team that has undertaken this assurance engagement has extensive experience in conducting assurance
on environmental, social, ethical and health and safety information, systems and processes, and provides noconsultancy related services to Cigna in any respect.
Other Matters - observations
We have provided Cigna with a separate management report with our detailed (non-material) findings andrecommendations. Without affecting the conclusion presented above, we have the following key observation:• Cigna must undertake a process to quantify their Scope 1 emissions associated with back-up andemergency generators, and refrigerants.

Beth Wyke
Head of Corporate Assurance Services
Malvern, PA
July 5, 2023
ERM Certification & Verification Services Incorporated
www.ermcvs.com | post@ermcvs.com

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All Cigna Healthcare products and services are provided exclusively by or through operating
subsidiaries of The Cigna Group. All Evernorth Health Services products and services are provided
exclusively by or through affiliates of the Evernorth companies. 973591 07/23© 2023 The Cigna Group. Some content provided under license.