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Cigna reported third-quarter revenue of $73.7 billion, up from $69.7 billion a year earlier and above the consensus. Its adjusted earnings per share of $7.98 also exceeded the consensus. Diluted earnings per share fell to $6.44 from $6.98 a year earlier.
In its filing, Cigna said pharmacy revenue growth reflected changes in the mix of claims, while premium increases within Cigna Healthcare drove higher premiums. Evernorth’s adjusted revenue increased, although its adjusted pretax operating income fell as the company invested in client and customer initiatives.
Cigna Healthcare’s adjusted revenue rose on higher premiums, largely reflecting rate increases, according to the filing. Its pretax adjusted income from operations also increased, helped by investment income and a lower expense ratio.
Cigna reported an operating margin of 3.25%, compared with 3.70% a year earlier. Free cash flow was $2.6 billion, down from $3.1 billion.
| Q3 FY2026 | Q3 FY2025 | Change | |
|---|---|---|---|
| Revenue | $73.7 billion | $69.7 billion | 5.64% |
| Diluted EPS | $6.44 | $6.98 | −7.78% |
| Gross margin | 88.5% | 88.8% | −0.3 percentage points |
| Operating margin | 3.25% | 3.70% | −0.4 percentage points |
| Free cash flow | $2.6 billion | $3.1 billion | −18.1% |
| Against the consensus | Reported | Consensus | Result |
|---|---|---|---|
| Adjusted EPS | $7.78 | $7.58 | Beat by 2.64% |
| Revenue | $71.6 billion | $71.4 billion | In line |
Adjusted EPS is the figure the consensus estimates, not the GAAP EPS above.
What management said on the call
CEO Brian Evanko said Cigna’s specialty and care services business grew earnings in the quarter, helped by its specialty pharmacy and distribution operations. CFO Ann Dennison said pharmacy benefit services results reflected contract renewals and extensions as well as investment in the transition to Signature.
Evanko described Signature as a “simple fee-based transparent solution for clients and customers.” He said its design phase was complete and Cigna was negotiating contracts with pharmaceutical manufacturers and network pharmacies. Cigna Healthcare’s fully insured book is the next planned adopter, with broader adoption across Evernorth expected in 2028. Asked about contracting progress, Evanko said Cigna was also educating brokers, employers and prospective clients.
On demand, Evanko said Cigna was tracking toward high pharmacy benefit client retention and at least 2,000,000 new pharmacy benefit services customers in 2027, including customers won from other pharmacy benefit managers. He said lower volumes from health plan clients had contributed to a decline in scripts and customer counts in 2026.
Dennison said Cigna Healthcare’s medical cost “trends remain elevated but stable and costs remain consistent with our pricing assumptions.” Asked about stop-loss pricing, she said indicators including the frequency of high-cost claims were consistent with expectations, and that Cigna planned to recapture a portion of its margin this year and another portion in 2027.
Dennison said the ACA exchange exit would create an approximately $200.0 million headwind, including remaining overhead and runoff costs. Evanko said Cigna would wait until its fourth-quarter call for detailed 2027 segment and subsegment guidance. Dennison said she expected fourth-quarter operating cash flow to follow the pattern observed in the prior two years.
Guidance
Cigna raised its full-year 2026 adjusted earnings per share outlook to at least $30.60. Dennison also raised the Cigna Healthcare pretax adjusted earnings outlook to at least $4.6 billion and narrowed the medical care ratio range around its unchanged 84.2% midpoint.
| Metric | For | Guide | Previous guide | Change |
|---|---|---|---|---|
| Revenue, Specialty Distribution Net New | FY2030 | $20.0 billion | — | New |
| Operating expenses, Accelerate To One Gross Savings | FY2030 | $3.0 billion | — | New |
| EPS, non-GAAP | FY2030 | $45.00 | — | New |
| Customers, Pharmacy Benefit Services New Customers | FY2027 | 2,000,000 | — | — |
| Customers, Pharmacy Benefit Services Retention | FY2027 | Cigna expects pharmacy benefit services client retention in the high 90s for FY2027. | — | — |
| Operating margin, Cigna Healthcare Stop Loss | FY2027 | Cigna expects continued improvement in its stop-loss margins in FY2027. | — | — |
| Operating income, Evernorth Non Gaap Growth | FY2027 | Cigna expects Evernorth earnings to grow by low single digits in FY2027. | — | — |
| Operating income growth, Cigna Healthcare Non Gaap Growth | FY2027 | 6.00%–9.00% | — | New |
| Revenue, Growth | FY2027 | Cigna expects attractive enterprise revenue growth in FY2027. | — | — |
| EPS growth, Non Gaap Growth | FY2027 | $0.10 | — | New |
| Debt, Debt To Capital Ratio | FY2026 | Cigna expects a debt-to-capital ratio of approximately 40% by the end of FY2026. | — | New |
| Operating cash flow | Q4 FY2026 | Cigna expects strong operating cash flow in Q4 FY2026. | — | — |
| Net margin, Aca Exchange | FY2026 | Cigna expects its ACA exchange business to be profitable in FY2026, with margins below its target range. | — | — |
| Operating expenses growth, Cigna Healthcare Medical Care Ratio | FY2026 | 84.2%, plus or minus 25 basis points | — | New |
| Operating income, Cigna Healthcare Non Gaap | FY2026 | $4.6 billion | — | New |
| Operating income, Evernorth Non Gaap | FY2026 | $6.9 billion | — | New |
| EPS, non-GAAP | FY2026 | $30.60 | $30.45 | Held |