Hello and welcome to the Annual Meeting of Shareholders of Cigna Corporation. Please note that today's meeting is being recorded. During the meeting, we will have a question and answer session. You can submit questions by clicking the Q&A button to open the panel. It is now my pleasure to turn today's meeting over to Mr. Cordani, President and CEO of Cigna. Mr. Cordani.
Hello, everyone. Cigna's 2021 annual shareholder meeting. I'm David Cordani, President and CEO, and I'm pleased to be joined by our Board of Directors and our Enterprise Leadership Team. We appreciate you taking time to join us by phone again this year. Today, I'm going to share some highlights about our ongoing leadership through COVID-19, our 2020 financial performance, and our long-term growth strategy. Cigna Chairman Ike Harris and our Corporate Secretary Julia Brncic will conduct our formal meeting. Afterward, Ike and I will open the call for questions. Now, 2020 was unquestionably an extraordinary year, with a monumental health crisis, deep and complex social issues, and heightened political tensions, each of which would have defined a unique year in its own right.
I couldn't be more proud in the way in which our more than 70,000 colleagues around the globe showed up every day to ask the question of what more we could do to make a difference and have an impact. From the start of the pandemic, we took a number of bold and decisive actions. First, we moved quickly to remove cost as a barrier to care. We were among the first to take steps to ensure that our customers had access to the COVID-19 testing and treatment they needed. We guarded them against surprise bills through our Customer Protection Program, and we launched Express Scripts Parachute Rx, a lower prescription cost program for the uninsured. We also acted to ensure our patients had continuous access to care by leveraging our supply chain expertise to ensure consistent prescription drug delivery. Our U.S.
medical business ramped up to meet the huge increase in demand for behavioral health services by significantly growing the breadth of our network and adding virtual provider partners. In addition, we delivered meaningful and innovative solutions to help our clients, such as our COVID-19 high-risk dashboard, which helped employers decide whether their colleagues can return safely to work sites. We extended our COVID-19 response to our communities. For example, in partnership with New York Life, we established a Brave of Heart Fund to provide grants for families of frontline healthcare workers who lost their lives to COVID-19. At the same time, we spoke out against racism and reaffirmed our commitment to diversity, inclusion, equity, and equality, including the launch of our five-year Building Equity and Equality Program. As we delivered for our customers, our clients, our partners, and our communities in 2020, we also balanced our commitment to our shareholders.
Among our accomplishments, we completed the integration of Express Scripts and achieved all of our integration priorities, including revenue growth, cash flow generation, and strong client and talent retention levels. We took the next step along our strategic path by launching Evernorth, our health services platform. We further strengthened our financial flexibility by closing the $6.2 billion sale of our group disability and life business to New York Life, while also delivering on our commitment to deleverage the company by reducing our debt-to-capitalization ratio to 39.5% by year-end. As a testament to the strength of our underlying business, even in these most dynamic environments, we extended our long proven track record of success with another year of strong financial performance in 2020.
This includes adjusted revenue of $160 billion, up 14% year-over-year, adjusted earning per share of $18.45, up 8%, and continued strong operating cash flow from operations of $10.4 billion. As we look ahead, we see three fundamental forces changing healthcare: pharmacological innovations, which will explode at an accelerating rate over the next decade, a greater recognition and acceptance of the link between mental and physical health, and care access models that are rapidly changing with a heightened focus on matching customers' needs at optimal sites of care through virtual health and other services. We are well-positioned to leverage these trends to meet the needs of our stakeholders over our three growth platforms: Evernorth, our U.S. medical portfolio, which includes U.S. commercial and U.S. government, and our international markets portfolio.
Across these three growth platforms, we relentlessly execute a durable growth framework, which has three primary building blocks: first, delivering differentiated value each and every day, second, expanding our capabilities through ongoing innovation and partnership, and third, through expanding our addressable markets. Guided by this growth framework, we're leveraging our leading capabilities to deliver innovative and flexible solutions to meet the needs of those we serve and to drive sustained, attractive growth. Over the long term, we expect to deliver 6%- 8% adjusted revenue growth and 10%- 13% adjusted EPS growth on average, along with a very attractive dividend. We expect to generate $50 billion in cumulative cash flow from 2021- 2025, which will give us financial flexibility to return capital to our shareholders through a variety of mechanisms, including share repurchase, quarterly dividends, and ongoing investments in our business.
Before I close, I want to again thank our more than 70,000 colleagues around the globe who've contributed to this ongoing strong performance and have helped to lead the way in 2020 through an incredibly challenging year. Our strategy to be champions of healthcare that is affordable, predictable, and simple has never been more important. We remain steadfast in our commitment to our customers, our clients, our patients, and our partners. We'd also like to thank you for choosing to invest in Cigna. We appreciate your commitment to our company, and we remain dedicated to our mission of improving the health, well-being, and peace of mind of those we serve each and every day. Now, I'd like to turn the meeting over to our Cigna Chairman Ike Harris and our Corporate Secretary Julia Brncic.
Thank you, David. Good morning, ladies and gentlemen. My name is Ike Harris . I am the Independent Chairman of the Board of Cigna Corporation. Thank you very much for joining us Cigna's annual shareholder meeting. Posted on the meeting website is a copy of the agenda and rules of conduct and procedures for today's meeting. Also present Cigna's Corporate Secretary, Julia Brncic. I would now ask the Corporate Secretary to establish that this 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. Ms. Maria Verzutti, 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 office. Cigna Corporation also received certain affidavits of mailing establishing that notice of this meeting, Cigna's proxy statement and annual report, were mailed or made available on or about March 19, 2021, each Cigna shareholder of record as of the close of business on the record date of March 8, 2021. In addition, based upon information provided by the Inspector of Election, I confirm that a quorum is present today Cigna's 2021 annual meeting of shareholders.
A list of shareholders as of the record date is included on the meeting website. There are seven 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 of 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 seven proposals set forth in the agenda, each of which was Cigna's proxy statement for this annual meeting.
Because no other notices were submitted within the advance notice period of Cigna'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. The proposals and the voting thresholds required for approval of each proposal are all described in the proxy statement. Ms. Brncic, would you please present the first item of business?
Mr. Chairman, I move for the election of 12 directors as follows: David Cordani, William Delaney, Eric Foss, Elder Granger, Isaiah Harris, Jr., George Kurian, Kathleen Mazzarella, Mark McClellan, John Partridge, Kimberly Ross, Eric Wiseman, and Donna Zarcone, 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. Brncic, 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.
Second.
Ms. Brncic, would you present the third item of business?
I move for the approval of the amended and restated Cigna long-term incentive plan.
Is there a second?
Second.
Second.
Ms. Brncic, would you please present the fourth item of business?
I move for the ratification of the appointment of PricewaterhouseCoopers LLP as the corporation's independent registered public accounting firm for 2021.
Is there a second?
Second.
Ms. Brncic, would you please present the fifth 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 now like to 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. Can you hear me okay?
We can hear you, sir.
Proposal five, Sheryl O'Reid to act by written consent. Sheryl's request that our Board of Directors take the necessary steps to permit written consent by the shareholders entitled to cast a minimum number of votes that would be necessary to authorize an action at a meeting at which all shareholders entitled to vote thereon were present and voting. This proposal topic won our outstanding 63% shareholder support at our 2019 annual meeting. It is important to adopt this proposal because Cigna shareholders have a very limited right to call for a special shareholder meeting. All shares not held for one unbroken year are immediately disqualified as though the shares were not even owned. Shareholders who own 25% of our shares for one unbroken year could determine that they actually own over 40% of company stock if the holding period is not counted.
Taking action by written consent in place of a meeting is a means Sheryl can use to raise important matters outside the normal annual meeting cycle, like the election of a new director. A Sheryl O'Reid to act by written consent may be a way to motivate a poor-performing director. For instance, Ms. Donna Zarcone received the most shareholder rejection votes in 2020. Ms. Zarcone is a former CEO who chairs the executive pay committee. This is like having a union organizer determine the hourly wages at a company. Being a former CEO could tend to make Ms. Zarcone a champion of CEO rights at the expense of shareholders. People tend to favor members of their peer group. Cigna shareholders gave a 15% rejection to the 2020 Cigna management pay when a 5%- 10% rejection is the norm.
It is also important to adopt written consent to make up for the loss of the Sheryl O'Reid to an in-person annual shareholder meeting. With the near universal use of online annual shareholder meetings starting in 2020, shareholders no longer have the right to discuss concerns with other shareholders and with their directors at a shareholder meeting, which can now be an online meeting, which is an inferior format to a Zoom meeting. Shareholders are also severely restricted in making their views known at an online shareholder meeting because all critical questions and comments can easily be screened out with the online meeting format. For instance, Goodyear management hit the mute button right in the middle of a formal shareholder proposal presentation at its 2020 shareholder meeting. Goodyear management did not want to hear a well-deserved critical shareholder statement.
Please vote yes, Sheryl O'Reid to act by written consent, proposal five.
Thank you, Mr. Chevedden.
Is there a second?
Second.
Thank you, Mr. Chevedden. Ms. Brncic, would you please present the sixth item of business?
The next item is a shareholder proposal submitted by Proxy Impact on behalf of the Roberta Sidney Revocable Trust. The shareholder proposal and supporting statement are set forth in the company's proxy statement. Operator, please open the line for Mr. Pasoff. I would now like to recognize Michael Pasoff, a representative of the Roberta Sidney Revocable Trust, for a period of five minutes to present the proposal.
Hi, good morning, everybody. My name is Michael Pasoff, and I'm the CEO of Proxy Impact, and I am representing Cigna shareholder Roberta Sidney. I'm here to speak to the gender pay gap shareholder resolution as asking Cigna to provide quantitative data so that shareholders can assess the company's pay gap and effectiveness of its policies to address this. This is the third year that shareholders have requested pay gap disclosure, and we keep refiling these resolutions because the company has responded with minimal or incomplete information. Best practice pay gap reporting consists of two parts: equal pay for your current job and equal opportunity to higher paying jobs. Adjusted pay gap data is used to determine equal pay, and unadjusted median pay data is used to identify equal opportunity.
After our first resolution in 2019, the board responded by producing a pay equity commitment statement that said, "We found no material difference in our pay data as related to gender or race," although it provided no information on what that data was. Shareholders want quantitative data and not qualitative assurances, and Cigna's lack of detail led us to refile the resolution in 2020 and 2021. This time, we asked Cigna to report on the adjusted and unadjusted median pay gap between all male and female employees, across race and ethnicity, including base bonus and equity compensation. The company responded that they would not provide unadjusted median data and that ended dialogues with the shareholders. This was a significant refusal, given that the gender pay gap is literally defined as the difference between median earnings of men and women relative to median earnings of men. The U.S.
Census Bureau, Department of Labor, OECD, and International Labor Organization consider unadjusted median pay a valid way of measuring gender pay gaps, yet Cigna is refusing to provide this definitive pay gap data point. The board's opposition statement to our 2021 resolution says that female employees earn $0.999 for every dollar earned by similarly situated male employees and that minority employees earn $0.997 for every dollar earned by similarly situated white employees. This sounds great, but once again, the board provides no supporting information to put this in context. Assertions of 99% equal pay are typically based on adjusted data that omits key employee groups, such as C-suite employees, where the highest level of gender and racial pay gaps occur. Cigna provides almost no details on how the data was adjusted, and again, it fails to provide any information on unadjusted median pay data.
By comparison, Cigna's U.K. operations are required by law to provide a gender pay report that includes mean and unadjusted median pay data. This report, which is similar to the one requested by the shareholder resolution, paints a very different picture than the no material difference claims of Cigna's U.S. operations. In fact, Cigna U.K. found significant differences, reported a 25% mean and a 22% median gender pay gap, a 34% mean and 15% median bonus pay gap. The board's three-year failure to provide any supporting data and the significantly different representations of the company's pay gaps in its opposition statement versus Cigna U.K. pay reports raise concern about Cigna's candidness when it describes its U.S. pay gaps. Quite frankly, the company looks like it's hiding something. It also begs the question, why aren't U.S. investors given the same transparent pay gap disclosure that U.K. investors are given?
It should come as no surprise then that Cigna received a D grade in the 2021 racial and gender pay scorecard. The scorecard compiles quantitative data on more than 50 large U.S. companies regarding their pay gap disclosures across five categories, including racial pay gap, gender pay gap, U.K. pay gap report, percent of employee coverage, and public commitments. To sum up, Cigna has failed to meet industry best practices or shareholder expectations on gender and racial pay gap disclosure. Cigna's opposition statement and website provide shareholders with a laundry list of its pay equity and diversity goals and policies, but does not provide data that would allow shareholders to assess its overall pay gap or the year-over-year effectiveness of these policies.
Cigna has repeatedly refused to provide median pay gap data, although it's one of the two key metrics used to evaluate pay gaps and one that Cigna already provides in the U.K. Investors seek and will continue to seek quantitative comparable data to understand Cigna's pay gaps and related policies. Thank you.
Thank you, Mr. Pasoff.
Is there a second?
Second.
Thank you, Mr. Pasoff. Ms. Brncic, would you please present the seventh item of business?
The next item is a shareholder proposal submitted by the National Center for Public Policy Research. The shareholder proposal and supporting statement are set forth in the company's proxy statement. Operator, please open the line for Mr. Danhof. I would like to recognize Justin Danhof, a representative of the National Center for Public Policy Research, for a period of five minutes to present the proposal.
Thanks so much and good morning. I'm Justin Danhof with the National Center for Public Policy Research, and I move proposal number seven, which seeks to increase the diversity on the company's board of directors. Across corporate America, company after company is adopting board diversity policy based on race and gender. These procedures have the stated goal of reducing corporate groupthink and require companies to interview an underrepresented minority and a woman for each open board spot. Folks, this isn't diversity. This is racism and it's sexism. Not all women think alike based on the fact that they are women. Similarly, not all Asian or Latino or Black Americans think the same based on their respective skin colors. We have a crazy idea. If you want to avoid groupthink, let's put together a team of leaders that actually think differently.
In this arena, there is clear Cigna's leadership suffers from a lack of diverse viewpoints. For example, the company wholeheartedly supports the Equality Act. This legislation would devastate women's sports. Did a single Cigna board member step up and ask why the company supports the destruction of women's and girls' sports in America? The evidence is here in your own backyard in Connecticut, where two biological males regularly crush their female counterparts in high school track events. The Equality Act would extend its insanity nationwide. Do the women who work here or employees with daughters, for that matter, stand by Cigna's stance that women's sports should be eviscerated in the United States of America? That's disgusting. The Equality Act would harm more than female athletics. It would cancel religious freedom. Full stop.
Which board member of this company stood up and asked why Cigna wants to cancel religious freedom? Did anyone have the courage? Do none of you simply care? I'm not sure which one of those is worse. Scholars with the Heritage Foundation have noted that, quote, "By excising the Religious Freedom Restoration Act from the legislation equation altogether, the Equality Act gives government free rein to restrict, compromise, or even eliminate the fundamental right to practice religion in pursuit of the Equality Act's political agenda." It wasn't long ago that religious freedom was a nonpartisan, globally accepted human right. As the Heritage Foundation experts explained, quote, "President Barack Obama called religious freedom a universal human right and an essential part of human dignity.
America, he said, proudly stands with people of every nation who seek to think, believe, and practice their faith as they choose." Is the entire Cigna board to the political left of Barack Obama? How did we get here? If so, that might explain the company shoving the wildly dangerous critical race theory training upon its staff. How offensive and pandering to tell your Black employees that they're suppressed? Are every single one of your white employees guilty of white privilege? Critical race theory and anti-racism trainings are a horrifying array of racist and toxic tropes that debase everyone that they touch. Critical race theory belongs in the ash heap of history, not in a corporate training. Are you really telling us, investors, that Cigna employees are all such snowflakes that they are offended by the terms "mankind," "blacklist," and "brown bag lunch"? This is nonsense.
This board needs some diversity. We believe that boards that incorporate diverse perspectives can think more critically and oversee corporate managers more effectively. Appointing a few conservatives may help this company avoid groupthink. That would be a win for investors and a win for actual diversity. Please join me in voting yes on proposal seven. Thank you for your time.
Thank you, Mr. Danhof.
Is there a second?
Second.
Thank you, Mr. Danhof. I would like to thank each of the shareholder proponents for taking the time to join the meeting today. 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 in the 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 your meeting website. If you've already submitted a proxy by mail, telephone, or electronically, you do not need to do anything further unless, of course, you want to change your vote. At this time, David Cordani and I will answer any appropriate questions that have been submitted in accordance with the rules of conduct and procedures available on the meeting site.
The business of the meeting. Thank you, Mr. Harris. We have allotted 15 minutes for our question- and- answer session. We received a few pre-submitted questions related to the business of the meeting. I'll read these questions and then ask our Chairman of the Board, Ike Harris, to respond. The first question relates to the gender pay gap proposal. Why does the Board recommend against a gender pay gap proposal?
Thank you for that question. As further described in the proxy statement, we are committed to compensating our employees equitably and competitively, regardless of gender. We believe, and we have always believed, that success depends on the collective strengths of our employees, and we're dedicated to attracting, retaining, and rewarding the performance of our diverse workforce. We proactively monitor our compensation programs for potential disparities, including conducting an annual review for pay equity disparities. We take action, as warranted, to address any disparities that may not be explained by objective factors. We perform these functions annually because we believe that compensation should be administered equitably.
We noted in the proxy that our most recent analysis indicated that female employees at Cigna earn $0.999 of every dollar earned by similarly situated male employees and that employees from underrepresented groups earn $0.997 for every dollar earned by similarly situated white males. Given the company's strong programs, practices, and disclosures, which we described in detail in the proxy statement, the board believes that the adoption of this particular proposal is unnecessary, as its implementation would not enhance Cigna's already established commitment to pay equity.
The second question relates to board diversity. Cigna's approach to board diversity?
We are committed to diversity at the board level and throughout our organization. At the board level, the Corporate Governance Committee works diligently to ensure that our board is composed of individuals with expertise in fields that are Cigna Corporation's business. They focus on experience from different professions and industries. There is an emphasis and focus on diversity of age, race, ethnicity, gender, and global experience. We adopted several years ago the so-called Rooney Rule, which requires that the Corporate Governance Committee and any search firm that we use include women and racially and ethnically diverse candidates in the pool of directors as we make our selections. I would point out to you that since 2018, seven directors have Cigna Corporation board.
Four of those seven new directors add to the racial, ethnic, and gender diversity of our board, and all have skills and experience that are Cigna's strategy. I would also point out that several board leadership positions are held by diverse directors, and more than half of our independent director nominees in this year's proxy are diverse. I would conclude with the statement that while we are pleased with the outcomes of our approach to board diversity, we remain committed to diversity and therefore look for improvement opportunities as our business strategy evolves.
The third question relates to our auditors. Has the company considered rotating audit firms?
The Audit Committee reviews the auditor services and staffing on a regular basis. Yes, the committee also periodically considers whether there should be a rotation of our audit firm. I would comment that in conjunction with the mandated rotation of the lead engagement partner, which is every five years, both the Chair of the Audit Committee and the Chair of the Board are involved in the selection of the PWC lead engagement partner. We believe the continued retention of PWC is in the best interests of the company and its shareholders. The firm has extensive knowledge in our business, which we believe enables a very effective audit.
How much did we pay the auditors in 2020 and 2019?
The difference in pay or fee paid to the auditors in 2020 versus 2019 is actually a very small variation. I would ask David Cordani, our CEO, to talk about the specifics. From a governance standpoint, we negotiate and review fees continually because given the complexity of our audit, there are situations where the original fee and the ultimate fee are different because of unanticipated events. Mr. Cordani, would you supply the specifics associated with that?
Sure, Chairman Harris. The specific audit fees year-over-year are disclosed in our annual proxy materials. I do not have them at my immediate fingertips, as Ike noted. They vary year to year, and there's a little fluidity within the course of the year relative to additional activities. The headline is the audit fees on a pure audit basis went down year-over-year. Given projects based on mergers and acquisitions and other support programs are varied. The net fee structure is down somewhat year-over-year, and as Mr. Harris noted, a relatively de minimis overall change. You could find those details of the aggregate fees noted in our annual filings.
Mr. Chairman, the Carpenter Pension Funds hold 313,500 shares of the company's common stock. As long-term investors, we believe the executive compensation plan should be designed to drive the successful execution of the company's long-term strategic business plan. We support the company's plan as a well-conceived and fair plan. With regards to proposal three, amending the long-term incentive plan, can you or the Chair of the Compensation Committee explain what type of amendments the board is able to make unilaterally to the plan without shareholder support, and the rationale for seeking approval to provide equity compensation to those who are neither employees nor directors of the company? Thank you.
The proposal for equity compensation to those individuals who are neither employees nor members of the company, so to speak, is brought about by our governance document. Obviously, this is an area whereby we must have shareholder approval. By the way, we think that's appropriate. It literally focuses on the equity portion of the director's compensation. Given the existing plans prior to this proposal, the company had reached a point whereby there was not sufficient equity flexibility, if you will, to continue the current plans. It is also, I would note, a trend that is taking place in other organizations whereby plans are being amended so that equity can be presented in a uniform way to more stakeholders to align, obviously, those stakeholders with the interests of the stockholder.
There are no further questions. I now turn the meeting back to Mr. Harris.
Thank you this morning for the questions being submitted. I would now note that the polls are about to close. If you wish to vote and have not done so, please do so now. I will now pause momentarily for approximately 20 seconds- 30 seconds to allow you that final voting opportunity. I hereby declare the polls closed. At this time, I would request that the Corporate Secretary read the preliminary vote report.
The Inspector of Elections has preliminarily determined that the 12 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. The advisory resolution on executive compensation has been approved. The amended and restated Cigna long-term incentive plan has been approved. The appointment of PricewaterhouseCoopers as the company's independent registered public accounting firm for 2021 has been ratified. The shareholder proposal regarding shareholder action by written consent has not received majority support, and the shareholder proposal regarding a gender pay gap report has not received majority support. The shareholder proposal regarding a board ideology policy 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 days of this meeting. I move to adjourn this meeting.
Is there a second?
Second.
I declare the 2021 annual meeting of shareholders adjourned. Thank you again for taking the time to join us this morning.
Thank you for joining us today. This concludes the meeting. You may now disconnect.