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 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.
Good morning. Welcome to Cigna 's 2020 annual shareholder meeting. I'm David Cordani, Cigna 's President and CEO. Unfortunately, circumstances prevent us from hosting our usual in-person meeting this year. We thank you for understanding and for taking time to join us by phone today. We also have members of our Board of Directors and our enterprise leadership team joining us today. Today I'll briefly talk about our company's performance. Following my remarks, Cigna 's Chairman Ike Harris and our Corporate Secretary Julia Brncic will conduct our formal meeting. Ike and I will open the call to your questions. It is no doubt that 2019 was a strong and defining year for Cigna . We delivered on our mission to improve health, well-being, and peace of mind of those we serve and produced outstanding financial results.
We achieved this performance all while integrating and merging the operations and cultures of two great companies, Cigna and Express Scripts. As a result, our customers and clients benefited from rolling out new innovative solutions for some of their more pressing healthcare needs, such as our Patient Assurance Program, which made insulin more affordable for patients with diabetes by capping the 30-day out-of-pocket cost of insulin at $25. Our Embarc Benefit Protection Program, which puts life-saving gene therapy within reach of those who need it. Our Digital Health Formulary, the industry's first, which helps customers and clients make better decisions from the 300,000 digital health tools that are out there. For our shareholders, they benefited as well from growth in our key businesses, which generated consolidated adjusted revenue of $140 billion.
We grew adjusted income from operations per share by 20% to $17.05, and we exceeded the guidance that we had already raised each quarter during 2019 for revenue, earnings, and earnings per share, and generated outstanding cash flow from operations. We were able to accelerate our focus on being the undisputed partner of choice for healthcare through partnerships such as those with Prime Therapeutics to make pharmacy care more affordable for Prime's 28 million members, and with Oscar Health, which gives small business access to affordable, fully insured health plans with broader choices that prioritize whole person health. I am extremely proud of what our team of more than 70,000 colleagues around the world were able to achieve in a highly dynamic and challenging environment.
However, I recognize fully what defines our great company in 2020 is not what we achieved in the past 12 months or 6 or even 3. Rather, it's what we are doing today to lead the healthcare industry's response to COVID-19. Here we have an equally compelling story to tell as well. I'm tremendously proud of how our colleagues have stepped up to this emergency across the globe, leveraging the best of who Cigna is, offering our global health services, and continuing to rise to meet the need of our customers, clients, and patients. In the U.S., we have taken definitive steps to make care more affordable by covering all out-of-pocket costs for COVID-19 related to testing and treatment.
We've expanded access to care by connecting more people through telehealth services and virtual care and deploying hundreds of our own clinicians to further extend those resources and provide greater predictability and peace of mind to ensure our customers have access to their medication by offering free standard shipping for home delivery of up to a 90-day supply of maintenance medication. We also launched a social connector pilot within our Medicare Advantage business, with colleagues from our retention and welcome call teams proactively calling senior customers just to see how they're doing or to check in if they need anything. Internationally, our colleagues have helped to ensure we are leading as well on a global stage.
For example, in the midst of the pandemic's early development, our China joint venture team quickly raised $300,000 to distribute medical supplies in China, and the China team quickly launched and deployed eight major new products or service initiatives, including 24/7 emergency hotlines, streamlined claim settlement processes for financial peace of mind, expanded hospital access, cancellation of deductibility limits, and advanced payments of claims. We've also taken numerous steps to protect the needs of our colleagues and their families around the globe by offering assistance with work at home capabilities, 10 days of emergency paid time off for COVID-19-related absences through 2020, and additional assistance and premium compensation for worksite-dependent employees. We know this is an unprecedented health challenge that the world is facing with COVID-19, and it was beyond anything anybody expected for 2020.
That's why we're continuing to rise to this challenge, including just recently announced this week our partnership and co-founding of the Brave of Heart Fund. Our track record of success, service, and innovation positions us well for ongoing success, growth, and impact for our customers, our patients, our clients, and our partners. Now, to bring this to a close, I'd like to thank our Cigna colleagues around the globe who create our results and build the impact we have on our customers and patients every day. I want to thank you for choosing to invest in Cigna. We are privileged to serve more than 170 million customer relationships around the world. Altogether, the work we are doing and the actions we are taking embody the mission that we have, which is to improve the health, well-being, and peace of mind of those we serve.
Now, I'll turn the call over to Cigna's Chairman Ike Harris and our Corporate Secretary Julia Brncic, who will conduct the balance of our formal meeting.
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 today for Cigna 's annual meeting of shareholders. Posted on the meeting website is a copy of the agenda and rules of conduct and procedures for today's meeting. Also present today is 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. Jeanette Rocha from Computershare 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. Cigna also received certain affidavits of mailing establishing that notice of this meeting, along with Cigna 's proxy statement and annual report, were mailed or made available on or about March 13th, 2020, to each Cigna shareholder of record as of the close of business on the record date of February 24th, 2020. In addition, based upon information provided by the Inspector of Election, I confirm that a quorum is present today to conduct Cigna 's 2020 annual meeting of shareholders.
A list of shareholders as of the record date is included on the meeting website. There are five 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 five proposals set forth in the agenda, each of which was detailed in Cigna 's proxy statement for this annual meeting.
Because no other notices were submitted within the advance notice period in 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 threshold 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, Ike Harris, Román Martínez IV, Kathleen Mazzarella, Mark McClellan, John Partridge, William Roper, 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 now present the second item of business?
I move for the approval of the advisory resolution on executive compensation.
Is there a second?
Second.
Ms. Brncic, would you present the third item of business?
I move for the ratification of the appointment of PricewaterhouseCoopers LLP as the corporation's independent registered public accounting firm for 2020.
Is there a second?
Second.
Ms. Brncic, 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's representative, Glen Beatty, for a period of five minutes to present the proposal. Operator, will you please open the line for Mr. Beatty?
Mr. Beatty, your line is now open.
Thank you. Proposal four. Can the people hear me all right?
Yes.
Yes.
Proposal four, shareholder right to call a special meeting sponsored by John Chevedden of Redondo Beach, California. Resolved. Shareholders ask our board to take steps necessary to amend our bylaws and each appropriate governing document to give holders in the aggregate of 10% of our outstanding common stock power to call a special shareholder meeting. Special shareholder meetings allow shareholders to vote on important matters, such as electing new directors that can arise between annual meetings. This proposal topic won more than 70% support at Edwards Lifesciences and SunEdison . Nuance Communications shareholders gave 94% support to a 2018 shareholder proposal calling for 10% of shareholders to call a special meeting. The aim of this proposal is to enhance shareholder rights like the 2019 shareholder proposal that won 63% support at Cigna to give shareholders the right to act by written consent.
Dozens of Fortune 500 companies provide for both shareholder rights to act by written consent and to call a special meeting. There's an important omission in the 2020 Cigna proxy statement in regard to the management argument that goes with this proposal. Management omitted in a key place that the 25% of shares that can now call a special meeting has an additional restriction. Such shares must be held continuously for one year. This is an important restriction. It is possible that 1/3 of Cigna shares are not held continuously for one year. The omission of this important fact next to this proposal, which could be called sneaky, is all the more reason to vote for this proposal. Given this important fact omission in a key place in the proxy, shareholders can consider whether the Chairman of the Corporate Governance Committee, Ms. Donna Zarcone, deserves the vote of shareholders.
Please vote yes, shareholder right to call a special meeting proposal four.
Thank you, Mr. Beatty.
Mr. Beatty has presented the proposal. Is there a second?
Second.
Thank you, Mr. Beatty. Ms. Brncic, would you please present the fifth 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. Passoff. I would like to recognize Michael Passoff, a representative of the Roberta Sidney Revocable Trust, for a period of five minutes to present the proposal.
Mr. Passoff, your line is now open.
Hi, good morning, everybody. I'm here to speak to the shareholder resolution that's asking Cigna to report on standard pay gap. This is the second year we have filed this resolution, and I'd like to acknowledge that the company has taken several good steps to address this issue. We refiled this issue because the company has still not provided unadjusted median pay data, which is the most common metric that investors seek when evaluating this issue. In fact, the gender pay gap is literally defined as the median pay gap between male and female full-time earnings by the U.S. Department of Labor, U.S. Census Bureau, Organization for Economic Cooperation and Development, the International Labor Organization, and this data is also required of companies operating in the United Kingdom.
While pay equity data as provided by the company is related to the issue, the data is not a stand-in for pay gap disclosures. Pay gaps are comprised of two parts: equal pay for your current job and equal opportunity to higher paying jobs. Median pay gaps reflect the lack of equal opportunity. Median pay gap disclosures can improve performance and provide a baseline for investors for measuring progress going forward. A 2019 study cited in the Harvard Business Review found that wage transparency in countries that mandate it narrowed the median wage gap. Citigroup was the first U.S. company to publish its global gender and U.S. minority pay gap in January 2019. It has since shrunk those gaps two and one points, respectively, year -over -year. Starbucks and Mastercard have since adopted the same best practice disclosures for their global operations.
There are many ways to shrink the gender and racial pay gap at a company: improving diversity, ensuring statistically adjusted equal pay for equal work, advancing women and minorities into positions of leadership. The only benchmark to measure whether the pay gap is actually shrinking from these various levers is to publish the pay gap itself. The question we're asking today is why aren't Cigna 's U.S. investors given the transparent pay gap disclosures that United Kingdom investors are afforded, where the act of disclosure has been shown to improve performance? Is it willing to provide equal pay data but not equal opportunity data by publishing its median pay gap? The board conflates fair pay for a given job with some transparent disclosure of how money is allocated across the organization to men and women, minorities, and non-minorities.
Cigna 's 2019 U.K. gender pay gap shows a 25% gender pay gap, which is an increase from 22% in 2018. It also shows a 34% gender bonus pay gap between male and female employees. As stated above, major U.S. and international organizations already utilize median pay gap data as a key data point. The company itself and all its peers within the United Kingdom operations are already disclosing median pay gaps in that country due to a government mandate. U.S. investors should be given the same information. We strongly urge you to support the proposal. Pay transparency has been shown to narrow pay gaps and improve the diversity of companies that disclose them, which we believe is in the long-term best interest of shareholders. Thank you.
Thank you, Mr. Passoff. Mr. Chairman, the proposal has been properly presented.
Is there a second?
Second.
Thank you, Mr. Passoff. I would now thank both of our shareholder proponents for taking the time today to join our 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 in our 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 link titled Cast Your Vote on the meeting website. Registered shareholders that have already submitted a proxy by mail, by telephone, or electronically need not do anything further unless, of course, you desire to change your vote. Voting instructions submitted by beneficial holders will revoke when the legal proxy to attend the meeting was issued, and such beneficial holders are now only able to vote at the annual meeting.
At this time, David Cordani and I will answer any questions you may have.
Thank you. There are no questions at this time. I'll now turn the meeting back over to Mr. Harris.
Given that there are no questions, I will now conclude this portion of our meeting. The polls are open, and I would encourage you to cast your vote as soon as possible. I will pause momentarily to allow you to complete that process. I hereby declare the polls closed. At this time, I would request the Corporate Secretary to read the preliminary vote report.
The Inspector of Election has preliminarily determined as follows: 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 appointment of PricewaterhouseCoopers as the company's independent registered public accounting firm for 2020 has been ratified. The shareholder proposal regarding the right to call a special meeting with a 10% threshold has not received majority support. The shareholder proposal regarding a gender pay gap report 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 of this meeting. Mr. Chairman, I move to adjourn this meeting.
Is there a second?
Second.
I declare the 2020 annual meeting of shareholders adjourned. Thank you very much for taking the time to join us today. Have a great day.
Ladies and gentlemen, this concludes today's conference call. Thank you for participating.