Hello and welcome to the annual meeting of shareholders of The Cigna Group. Please note that today's meeting is being recorded by Broadridge. Recording of this meeting by any other person is strictly prohibited. During the meeting we will have a question and answer session. You can submit questions or comments at any time by clicking on the message icon. It is now my pleasure to turn today's meeting over to Mr. David Cordani, Chairman and CEO of The Cigna Group. Hello everyone. Welcome to The Cigna Group's 2025 annual shareholder meeting. I'm David Cordani, Chairman and CEO, and I'm pleased to be joined by our Board of Directors and our enterprise leadership team. We thank you for joining us for today's meeting.
In my remarks today, I'll briefly discuss our 2024 performance and how our company continues to support our customers, patients, clients, and partners throughout the year and how we are navigating a dynamic environment and working to make improvements across our company for the benefit of those we serve. After that, along with our Corporate Secretary, Kari Stevens, we will conduct our formal meeting. We will open the call for questions. I'll start by reviewing our business and financial performance. The Cigna Group continues to grow in 2024 while taking critical steps to deliver on our mission to improve the health and vitality of those we serve. In 2024, our company grew full year total revenues to $247.1 billion, an increase of 27% year over year.
We achieved shareholders net income of $3.4 billion or $12.12 per share, and adjusted income from operations of $7.7 billion or $27.33 per share, which reflects an increase of 9% year over year. We generated cash flow from operations of $10.4 billion and we returned $8.6 billion to shareholders through dividends and share repurchase and we expanded our total share repurchase authorization to $10.3 billion. Taken together, our results and our achievements demonstrate how Evernorth Health Services and Cigna Healthcare are strategically positioned for sustained, attractive growth in Evernorth, our health services platform. We continue to drive top and bottom line growth by creating value for those we serve through our pharmacy benefit services and our specialty and care businesses. We also continue to innovate to address some of the biggest challenges facing clients and patients today.
For example, through our continued leadership of biosimilars, we began dispensing our Humira interchangeable biosimilar last summer with $0 cost for our patients. This translates into savings for patients on average of $3,500 per year. As another step forward, we announced the Stelara Biosimilar which will be available this year also at zero dollar cost for our patients. Another example of how we continue to lower prices for patients while delivering savings for our clients is with the GLP-1 drug class. We all know that they have high manufacturing list prices and Americans are paying a much higher multiple for GLP-1s than other countries even with all discounts and rebates considered.
We are proud that EncircleRx, our solution that provides a series of clinical programs along with GLP-1 medications to support sustained lifestyle change, grew to approximately 8 million lives enrolled at year end 2024 and as of today has nearly 10 million customers enrolled in it. Now in Cigna Healthcare, our health benefits platform, we work to meet the needs of employers of all sizes and individuals throughout 2024. Among our accomplishments, we enrolled 6.5 million individuals in Pathwell Specialty, which guides patients in need of specialty medications to more comfortable sites of care and more cost effective providers, sometimes in the care of their own home. Additional accomplishments include our partnership with HelloFresh to provide discounted meal deliveries to customers with complex medical conditions like multiple sclerosis, cancer and rheumatoid arthritis. We also further expanded our global presence in 2024 in international health.
An example of this is our recent expansion to further deepen our presence in the Kingdom of Saudi Arabia. Finally, as we continue our disciplined capital stewardship, we announced the sale of our Medicare business to HCSE which closed in early 2025, and we are looking forward to serving HCSE through our Express Scripts Pharmacy benefit service business going forward. Now, stepping into 2025, we intensely are listening to how Americans are feeling about and experiencing our industry more broadly. We recognize we can do more to lead and drive systemic change, and we're proud to be the first in our industry to announce a series of transformative changes to address some of the most pressing challenges in health care today.
These include easier access to care to make sure we are doing everything we can to remove delays and barriers to getting people the care they need and making our processes more simple, easier to follow, and faster. Second, by providing better support, we're expanding resources to work with patients and customers who are facing complex conditions to help them navigate through the healthcare system with greater ease. Next, improving better value to make sure people get the most for their dollars they spend, particularly around working to relentlessly lower the price of drugs. Fourth, driving greater accountability so that we're held accountable for and deliver on our commitments. Fifth and last, greater transparency to openly share our performance relative to these commitments. Now, looking ahead, there are three keys to our sustained success that we will continue to focus on.
First is we start with what makes us unique and that's our identity which we work to drive. A performance-based culture that couples an innate purpose-driven orientation to serve. It's this combination that enables us to improve the health and vitality of those we serve now. Second, it's through our strong set of capabilities and innovative culture in Evernorth and Cigna Healthcare that provide an ever-evolving portfolio of solutions. Third is our coworkers who bring their passion, empathy and skills every day to work for the benefit of those we serve. I'm personally inspired by the way our team guides customers and patients at the care they need and works relentlessly with employers to support their people, always seeking ways to have yet even a greater impact.
We're energized by the road we're on together, by the value we are continuing to deliver for the benefit of our stakeholders and by the next phase where we will seek to lead the transformation of healthcare for the better. In closing, I want to thank all of you, our shareholders. We appreciate your engagement and your careful thought process and decisions to invest in The Cigna Group.
Thank you, David. Now I'd like to welcome Kari Stevens, The Cigna Group's Corporate Secretary, to join David to begin the formal portion of our meeting.
Posted on the meeting website is a copy of the agenda and rules of conduct and procedures for today's meetings. I would now ask our Corporate Secretary to establish that a meeting has been duly called, that a quorum has been established, and also to review the protocol for today's meeting.
Thank you, Mr. Chairman. First, I would like to remind everyone that recording of this meeting is strictly prohibited. Mr. Chris Woods, a representative of Broadridge Financial Services, has been duly appointed as the Inspector of Election to tabulate the vote for today's meeting. The Inspector of Election has signed the necessary oath of office. The Cigna Group has also received certain affidavits of mailing establishing that notice of this meeting along with The Cigna Group's proxy statement and annual report were mailed or made available on or about March 14, 2025 to each shareholder of record of The Cigna Group as of the close of business on the record date of March 4, 2025. In addition, based upon information provided by the Inspector of Election, I confirm that a quorum is present today to conduct The Cigna Group's 2025 annual meeting of shareholders.
A list of shareholders as of the record date is included on the meeting website. A representative from PricewaterhouseCoopers LLP is also present today. There are four items of formal business for presentation at today's meeting. Following presentation of the proposals, we will have a question and answer period. At the conclusion of the question and answer period, we will conduct the voting, read the preliminary voting report, and adjourn the meeting. The polls will open when all the proposals to be voted on at this meeting have been presented. The polls will close immediately prior to the preliminary voting report. We will now proceed with the four proposals set forth in the agenda, each of which was detailed in The Cigna Group's proxy statement for this annual meeting.
Because no other notices were submitted within the advance notice period in The Cigna Group's bylaws, no nominations or proposals other than those in the proxy statement will be presented at this meeting.
On the basis of the Corporate Secretary's report, this meeting is duly convened and we will now turn to the proposals to be voted on today. Proposals and voting thresholds required for approval of each proposal are described in the proxy statement. Ms. Stevens, would you please present the first item of business?
Mr. Chairman, I move for the election of 11 directors. David Cordani and Eric Foss, Elder Granger, Neesha Hathi, George Kurian, Kathleen Mazzarella, Mark McClellan, Philip Ozuah, Kimberly Ross, Eric Wiseman and Donna Zarconi, all for one year terms expiring at the next annual meeting of shareholders or until their successors have been duly elected and qualified.
Do I hear a second? Second. I declare the nominations for the election of directors closed. Ms. Stevens, would you present the second item of business?
I move for the approval of the advisory resolution on executive compensation.
Is there a second?
Second.
Ms. Stevens, would you present the third item of business?
I move for the ratification of the appointment of PricewaterhouseCoopers LLP as the company's independent registered public accounting firm for 2025.
Is there a second?
Second.
Ms. Stevens, would you please present the fourth item of business?
The next item is a shareholder proposal submitted by John Chevedden. The shareholder proposal and supporting statement are set forth in the company's proxy statement. I would like to now recognize John Chevedden for a period of five minutes to present the proposal. Operator, please open the line for Mr. Chevedden.
Hello, this is John Chevedden. Proposal four, special shareholder meeting improvement. Shareholders ask the board of directors to remove the current provision that considers the voice of certain signatures as non shareholders. Currently, all shares not held for one continuous year are considered non shareholders if they seek to call for a special shareholder meeting on an important business matter. The current exclusion for all shares held for less than one continuous year makes the current so called shareholder right to call a special shareholder meeting useless. There's no point to have a useless right on the books of Cigna.
The reason to enable all shareholders to call for a special shareholder meeting is to allow one shareholder or a group of shareholders to quickly acquire Cigna shares to equal the challenging 25% share ownership requirement of all shares outstanding to call for a special shareholder meeting when there is an urgent business matter to consider in order to incentivize a turnaround of Cigna. The best strategies for turning around a company do not necessarily come from a company's existing shareholders. If Cigna is in an emergency situation, Cigna shareholders and potential Cigna shareholders will not even consider acquiring more shares in order to call for a special share of the meeting. If they have to sit on their shares for one year to call for a special shareholder meeting, a one year sit out makes no sense. An emergency demands an immediate response.
The fact that one shareholder or a group of shareholders can quickly acquire more shares to call for a special shareholder meeting is an incentive for Cigna directors to avoid such an emergency situation in the first place. Since the continued service of certain Cigna directors could be terminated by a special shareholder meeting, this is a good incentive for Cigna directors to have for the benefit of all shareholders. Please vote yes Special Shareholder Meeting Improvement.
Proposal 4.
Thank you, Mr. Chevedden.
Is there a second?
Second.
Thank you, Mr. Chevedden, for taking the time to join our meeting today.
There were no other proposals submitted in advance of the meeting.
That concludes the matters to be voted on as outlined in the Notice of Annual Meeting. Because no other proposals were submitted within the advance notice period set forth by bylaws, no other business matters will be presented at this meeting. The polls for voting at this meeting are now open. Shareholders may vote by clicking the button titled Voting on the meeting website. If you've already submitted a proxy by mail, telephone, or electronically, you do not need to do anything further unless you desire to change your vote. At this time, we will transition to the question and answer portion of the meeting. Along with Kerry Stevens, I am also joined by Eric Wiseman, The Cigna Group's Lead Independent Director.
Thank you, Mr. Cordani. I will read questions that have been submitted in accordance with the rules of conduct and procedures available on the meeting site. We have received questions related to the business of the meeting. I'll read those questions and then ask our Chairman and CEO David Cordani to respond. Our first question is how much was spent on dividends and share buybacks in 2024?
For 2024, first, to put it in context, we had approximately $10.5 billion of operating cash flow. I start there because it's an important item to highlight that we operate in a capital efficient business mix for our business port and have a good strong track record of operating cash flow delivery. Specific to the question, we deployed approximately $8.5 billion in form of both dividend as well as share repurchase. Additionally, our board increased our dividend again this past year and lastly, our board increased our share repurchase authority for the latter part of 2024 to approximately $10 billion. Thank you for your question.
Thank you, David.
Our next question is with the new administration in the U.S., how is The Cigna Group navigating and working with the.
White House.
Specific to the U.S., it's important to note that our business portfolio has and continues to operate in a very active legislative and regulatory environment, and as an organization we feel it's important to stay actively engaged on a principal basis relative to evolving legislation and regulation. Now, having said that, we do not see any existing pending legislation as being uniquely disruptive or impactful to our business model as we continue to innovate and operate our business portfolio. By way of themes, I would point back to legislative and regulatory activity around increasing transparency, which is a thrust that we actively support, bringing more transparency that is actionable for both consumers as well as employers and patients to make informed decisions, opportunities to further improve affordability or value for the benefit of individuals who are being served by health care programs and payer programs.
I point our shareholders back to a series of commitments we made even earlier this year. Our commitment to better one of those commitments points toward further improving value for the benefit of those we serve. Another commitment points toward further expanding support and advocacy programs for the benefit of those we serve. A final note I would make is our organization has a good sustained track record of continuing to innovate and evolve our products, our programs and services in a fluid regulatory and legislative environment. We expect to continue to do so as we look to the future. Thank you for your question.
Thank you, David.
Our next question is, given the competitive landscape within the health insurance industry, what specific strategies does Cigna employ to ensure strong ethical leadership and maintain a stable long term vision for the company and its stakeholders?
Relative to the question, I think I'll come back and start with grounding back on our mission statement, which presents a compass for how we lead the organization over a long period of time. That is, our mission is to improve the health and vitality of those we serve. In support of that, we have a value system when we lay out our values and we share those publicly. I'll cite a couple of those as an example and then I'll click it down. Our first value is we care deeply about our customers, our patients and our coworkers. Another value we talk about is building a better future together. I'm going to go to that second one because our company orients around partnership, partnering with those in the health and wellbeing ecosystem to build a better series of programs on a positive basis.
If we think about the challenge of the global pandemic as an example, both our mission, our values and our orientation around partnership were tested, I would say pretty meaningfully around the globe and how we were able to step forward with products, programs and services in support of those we served. An example of that is we stepped forward proactively to support and take on the financial obligation of all vaccinations. Above and beyond that, we were the first organization to proactively come forward and state that we would take care of all the financial obligations of individuals who were going through Covid treatment. We were guided by our mission in that action. We were not guided by a financial statement in terms of driving forward. Lastly, I would highlight our governance framework aided by our Board of Directors. Make sure that we are a well governed franchise.
Looking at the long term nature of our commitments, both through the diverse portfolio of our board members as well as well functioning committees. Our Board of Directors ensures that the leadership team of the organization is both delivering for today as well as well governed with an eye toward the future. Thank you for your question.
Thank you, David.
Our next question is around GLP-1s. Given the increasing demand and at times scarcity of GLP-1 medications and considering their significant impact on managing chronic conditions like diabetes and obesity, what are Cigna's strategies to ensure consistent coverage and patient access to these vital therapies? What is your perspective on the current supply chain challenges relative to GLP-1s?
Obviously a number one drug being discussed in the United States, specifically Global Access, but in the United States, first and foremost by way of the supply chain challenges that transpired early on and it mostly dissipated thus far. I'm pleased and proud to say our team has done phenomenal work to ensure that all of our customers and patients, specifically those insulin dependent diabetics who needed GLP-1 access had full access coordination and no disruption relative to access to products and services. Now, more broadly than that, as you may have seen in a lot of the headlines, there's an ongoing debate in the United States relative to coverage and access outside of insulin dependent diabetics or more specifically for weight management.
Corporations and governments of all sizes have been challenged to figure out how to best balance the need for and demand for access to GLP-1s by many relative to weight management with the ability to afford that. An example of a program that I'm very proud of that our organization has led in the industry and it's one of its kind today in the marketplace is our EncirClerx program. That is a program that employers have access to for not the insulin dependent diabetics, but for their population that are seeking weight management where we bring coverage, access to the pharmaceuticals, but importantly clinical programs, both nutritional behavior modification programs and care management programs to help individuals over their health and life journey.
We believe an innovation like that creates a more sustainable program for individuals to evolve their lifestyle and gain a better, more sustainable weight and be able to maintain that over the long term. To give you an idea of demand in the marketplace, while that product and innovation was brought forth in 2024, by the end of 2024 we served slightly in excess of 8 million individuals. Already this early in 2025, we're well in excess of 10 million individuals we're serving and our clinical and business teams are already innovating, evolve programs and services that are attached to it. Coming back to the top, we've been able to ensure access for insulin dependent diabetics with no disruption, access to the important pharmaceuticals they need in the GLP-1 class.
We continue to innovate products and programs that are individual specific, but for employers to balance the affordability and care access challenges, and our EncirClerx program is a great testament to our team's ability to innovate and evolve for the marketplace.
Thank you, David.
There are no further questions. I now turn the meeting back to Mr. Cordani.
Thank you. That now concludes our question and answer period. Now back to the polls. They are about to close, so if you wish to vote and have not yet done so, please do so now. We will pause momentarily. I hereby declare the polls closed at this time. I request that the Corporate Secretary read the preliminary vote report.
The inspector of election has preliminarily determined that the 11 director nominees have been elected as directors for terms expiring at the next annual meeting of shareholders or until their successors have been duly elected and qualified, that the advisory resolution on executive compensation has been approved, that the appointment of PricewaterhouseCoopers as the company's independent registered public accounting firm for 2025 has been ratified, and that the shareholder proposal regarding special shareholder meeting improvement has not received majority support. The final voting results for this meeting will be reported on a Form 8-K filed with the SEC within four business days.
Days of this meeting.
I move to adjourn this meeting.
Is there a second?
Second.
I declare the 2025 annual meeting of shareholders adjourned. We thank you again for taking time to join us today.
The meeting has now concluded. Thank you for joining and have a pleasant day.
The host has ended this call. Goodbye.