Key financial results
- Total revenue: The company reported third quarter 2026 adjusted revenue of $73.8 billion.
During the quarter, we delivered adjusted revenue of $73.8 million.
- Earnings: Adjusted after-tax earnings for the third quarter were $2.1 billion, with adjusted earnings per share of $7.98.
adjusted after-tax earnings of $2.1 million and adjusted earnings per share of $7.98.
- Special items: The company recorded after-tax special item charges of $146 million or $0.55 per share in the third quarter.
we recorded after-tax special item charges of $146 million or $0.55 per share
- Full year outlook: Management raised the full year 2026 adjusted earnings per share outlook to at least $30.60.
we now expect adjusted earnings per share of at least $30.60.
Business segment results
- Evernorth: Evernorth revenues grew 6% year-over-year to $63.8 million, and pretax adjusted earnings were $1.8 billion in the third quarter.
third quarter 2026 revenues grew 6% year-over-year to $63.8 million and pretax adjusted earnings were $1.8 billion.
- Specialty and Care: Specialty and Care Services pretax adjusted earnings grew 15% year-over-year to $1.1 million.
Specialty and Care Services delivered strong performance with pretax adjusted earnings growing 15% year-over-year to $1.1 million
- Pharmacy Benefit Services: Pharmacy Benefit Services delivered third quarter pretax adjusted earnings of $765 million.
In our pharmacy benefit services business in Evernorth, we delivered third quarter pretax adjusted earnings of $765 million.
- Cigna Healthcare: Cigna Healthcare adjusted revenues grew 9% year-over-year to $11.7 billion and pretax adjusted earnings were $1.2 billion.
Third quarter 2020 adjusted revenues grew 9% year-over-year to $11.7 billion and pretax adjusted earnings were $1.2 billion.
- Medical care ratio: The medical care ratio for the third quarter was 85%, which was in line with expectations.
The medical care ratio for the third quarter was 85% and in line with expectations
- Customer growth: Total medical customers grew 2% year-to-date to 18.5 million customers.
Total medical customers have grown 2% year-to-date to 18.5 million customers.
Capital allocation
- Cash flow: Third quarter operating cash flow was $2.6 billion.
Third quarter operating cash flow was $2.6 billion
- Debt: The debt to capitalization ratio was reduced by approximately 100 basis points to 41.8% as of September 30.
we reduced our debt to capitalization ratio by approximately 100 basis points to 41.8% as of September 30.
- Share repurchase: The company repurchased approximately 900,000 shares of common stock for approximately $250 million during the third quarter.
in the third quarter, we repurchased approximately 900,000 shares of common stock for approximately $250 million.
Industry trends and dynamics
- Medical costs: Medical cost trends continued to be elevated but remained consistent with expectations and pricing assumptions.
While medical cost trends continue to be elevated, they are consistent with our expectations and pricing assumptions.
- Rebates: Industry-wide gross rebate pools are experiencing compression.
the compression of industry rebate pools and lower employer coverage of GLP-1s for weight loss
Competitive landscape
- Generic adoption: Specialty generic adoption rates for Revlimid reached approximately 90%.
generic Revlimid, where penetration is now approximately 90%.
- Retention: Client retention rates in the pharmacy benefit services business remain high in the 90s.
along with strong retention rates in the high 90s.
Macroeconomic environment
- Regulation: Management noted a dynamic environment and highlighted regulatory changes including the Consolidated Appropriations Act of 2026 and the Department of Labor PBM fee disclosure rule.
consistent with the direction of regulatory changes, including the Consolidated Appropriations Act of 2026 and the Department of Labor's recently finalized PBM fee disclosure rule.
Growth opportunities and strategies
- Lead to One: The company introduced its Lead to One vision centered on delivering personalization at scale around medical, pharmacy, behavioral health, and specialty care.
we announced our Lead to One Vision, which is centered on delivering personalization at scale to improve affordability and the health care experience
- Accelerate to One: The Accelerate to One modernization and productivity initiative targets $3 billion in gross savings by 2030.
- HealthSense: HealthSense, a data and technology-powered customer engagement solution, was launched in September starting with oncology.
Financial guidance and outlook
- 2027 EPS growth: Management expects adjusted earnings per share growth of at least 10% in 2027 off run rate earnings for ongoing businesses of approximately $30.
continue to expect adjusted earnings per share growth of at least 10% in 2027 off our run rate earnings for our ongoing businesses
- 2030 target: The company remains confident in 2030 adjusted earnings per share of at least $45.
remain confident in 2030 adjusted earnings per share of at least $45
- Segment outlook: For full year 2026, Evernorth pretax adjusted earnings are expected to be at least $6.9 billion, and Cigna Healthcare pretax adjusted earnings are expected to be at least $4.6 billion.
Q3 2026 results
| Metric | Result | Change |
|---|---|---|
| Adjusted Revenue | $73.8 billion | Not stated |
| Adjusted After-tax Earnings | $2.1 billion | Not stated |
| Adjusted EPS | $7.98 | Not stated |
| Evernorth Specialty and Care Services Earnings Growth | 15% | year-over-year |
| Cigna Healthcare Pretax Adjusted Earnings | $1.2 billion | Not stated |
| Medical Care Ratio | 85% | Not stated |
How management sounded
Balanced (+35 on our -100 to +100 scale). Management expressed confidence in their Lead to One strategy and raised full-year guidance, while providing transparent, albeit cautious, commentary on 2027 transitional headwinds. Management sounded more upbeat than on 20% of the 302 calls we cover; most companies sound positive on their own calls, so the comparison says more than the label.
Read the analyst Q&A summary and guidance and outlook for this call.
What to watch before the next call
- Progress on the Signature model implementation and 2028 adoption ramp.
- Execution of the Accelerate to One initiative and realization of $3 billion in gross savings by 2030.
- Impact of 2027 headwinds, including industry rebate compression and GLP-1 coverage changes.
Earlier calls
- Q2 2026 (Jul 30, 2026), tone Balanced: The Cigna Group reported total revenues of $71.7 billion and adjusted earnings per share of $7.78 for the second quarter of 2026, raising its full-year adjusted EPS outlook to at least $30.45.
