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1 CIGNA ANNUAL REPORT | 2020 SHAREHOLDER LETTER1A MESSAGE FROM OUR PRESIDENT AND CEO David CordaniBy all accounts, 2020 was an extraordinary year. The health crisis, social unrest and political tensions that unfolded could have each defined a year in their own right; together they converged to create one of the most unsettling periods in modern history. Families and communities were rocked by fear, uncertainty, pain, loss and sorrow. It was a year that many of us hope to never see repeated. However, as I reflect back, I cannot help but also see the bright spots that were part of the picture: the valuable lessons many of us learned about compassion and empathy; the medical advances that led to the development of vaccines at a pace never before seen in human history; the joining together of countless voices worldwide to demand a more equitable and equal society; and the remarkable resilience shown by so many in the midst of the year s relentless a global health leader, Cigna navigated 2020 by staying focused on meeting and balancing the needs of those we serve and on keeping our promises.

2 This meant: Keeping our purpose to improve people s lives by delivering health, well-being and peace of mind front and center and taking meaningful steps throughout the year to fulfill this promise; Taking decisive action to support our clients, customers, patients, partners and communities in the wake of the global pandemic; 1 Speaking out against racism and reaffirming our commitment to diversity, inclusion, equity and equality, including by launching our Building Equity and Equality Program;2 and Delivering on our financial commitments to our shareholders by growing our adjusted revenue by 14%, to $160 billion, and delivering adjusted earnings per share of $ consistent with our overall , 4 You can see the complete summary of our 2020 accomplishments on the following couldn t be more proud of the way our more than 70,000 colleagues around the globe showed up every day to ask what more they could do to be a force for positive change, both inside and outside our company.

3 The results they achieved, for the benefit of our stakeholders, are a testament to their dedication and flexibility. It is a privilege to lead such an extraordinary and caring HEALTH CARE MORE AFFORDABLE IS A TOP PRIORITY AROUND THE GLOBE Health care costs continue to rise as populations age and become sicker. In addition, in the United States, pharmacological interventions are exploding at a rate and pace that far exceeds the growth of surgical and medical device interventions with spending on pharmaceuticals increasing 26% per capita from 2014 to That growth continues today with many of the preventive, curative and treatment innovations coming from the pharmacy space. One day, hopefully soon, we could see new drugs come to market to treat conditions such as Alzheimer s 2 SHAREHOLDER LETTER disease, heart disease and cancer. But with these advances come elevated costs as many researchers have calculated that expenditures for prescription drugs and other pharmacy services will continue to rise in the next 5 10 years.

4 This underscores the need to bring innovative thinking to the challenge of affordability by, for example, leveraging value-based care to drive access and care coordination, align incentives, and lower costs; dramatically evolving programs for chronic care by eliminating cost barriers to treatment to incentivize 100% drug adherence; and transforming business models to drive predictability and affordability for high-cost Cigna, affordability will continue to be our number one focus in 2021 as we recognize that individuals and companies alike need affordable solutions that enable them to achieve optimal health. Finding innovative ways to help them do that is the central underpinning of our overall THE STIGMA OUT OF MENTAL HEALTHWe all know that 2020 has taken a toll on the mental well-being of many across the country. Many people are feeling more isolated and lonely, and parents are feeling the stress of managing kids virtual homeschooling while trying to put in a day s work.

5 Studies have shown surging rates of anxiety and depression amid the At the same time, Americans are less equipped than ever to recover from these difficulties. Cigna s 2020 Resilience Index found that resilience is at risk for more than 60% of Americans and the most affected group is young adults age 18 23, the same group that self-classified as the loneliest generation in earlier studies we , there is greater recognition of the link between mental and physical health with the World Health Organization stating that there is no health without mental health. 8 This proclamation is backed by science showing that perceived stress is a risk factor for illnesses such as type 2 diabetes and heart disease and that someone with a chronic medical condition is seven times more likely to have an underlying mental health or substance-related the same time, the stigma associated with mental health persists, and those who most need help may be reluctant to seek treatment.

6 At Cigna, our goal is to ensure that our customers and patients receive the behavioral health services they need. With the largest virtual behavioral health network in the United States, we were well positioned to respond when demand for behavioral health services rose dramatically in 2020. Still, we continued to grow our virtual network throughout the year, increasing it by 150% to include more than 52,000 TECHNOLOGY AND DATA TO ENHANCE ACCESS TO AND PERSONALIZATION OF HEALTH Virtual care was widely embraced in 2020, but it s just the tip of the iceberg in terms of what s possible. Technology is enabling people to become more involved in their health than ever before, and it is a key driver of the expansion of home-based care, thanks to innovations such as smart glucometers, which remotely monitor the blood sugar levels of patients with diabetes. Studies have long demonstrated that innovations like these can reduce the need for hospital care and thus the costs for patients managing a chronic This type of rapid innovation will enable the delivery of more personalized care to address what people want and need, delivered where and how they want to receive believe that this type of care will also play an important role in rooting out health disparities from our health care system by expanding access to affordable care and treatment that breaks through cultural, social or geographic barriers.

7 That s why we re so excited about our recent agreement to acquire MDLIVE. This transaction will give us the opportunity to build a new model of care delivery, one that provides a connected experience with greater affordability, predictability and the opportunity to serve millions more people, and with more personalized ways to deliver care, we can have an even greater impact on our customers, clients and partners including those in historically underserved These are just some of the ways that Cigna is thinking about and forming the future, to make it better. We recognize that achieving our goals for an affordable, predictable and simple health care system will not be easy, but SHAREHOLDER LETTER34 SECTION NAME5we are fully committed. The stakes are too high not to be. We are well positioned to deliver on our purpose to make a difference in the lives of those we serve. When you put it all together, our purpose and our growth are inextricably linked: Our purpose fuels our growth, and our growth enables us to broaden our reach and impact.

8 This translates into more lives to change for the better and more resources to invest, all of which further accelerate meaningful value creation for you, our BETTER TOMORROWT oday, as the number of COVID-19 vaccinations steadily increases, communities around the globe are starting to envision life beyond the pandemic. One thing is clear: The environment will continue to be dynamic for the foreseeable future. We still face many challenges from reinvigorating our global economy to achieving the herd immunity that will enable life to return to some semblance of normal. But 2020 has shown us that we can tackle anything when we challenge old ways of thinking and innovate THE FUTURE OF HEALTH CAREEven as we continue to address the challenges of today, we must prepare for tomorrow. The pandemic has spotlighted gaps in our health care system that must be addressed, and it has accelerated trends that are reshaping the landscape.

9 At Cigna, we are not content to simply watch from the sidelines our purpose calls for us to be part of the solution. As such, there are a number of areas that we will continue to lean into in the year ahead that we believe will make a difference for those we serve and for our example, our community program launched in Houston, Memphis and South Florida to elevate support and services for some of those areas most disadvantaged In addition, our International Markets team launched an outreach program to encourage people and organizations to check in on and support one another as a way to strengthen emotional health and well-being amid the stress of the I ll say it again: I m proud of how Cigna delivered on our mission and lived our values during one of the toughest years for health care in modern history. I m equally energized by the opportunities that lie have the team and orientation to create positive have the assets and capabilities within our three growth platforms Evernorth, Medical and International Markets to make a difference for today and we have a growth framework that guides us, each and every day, to extend our reach and is from this strong foundation that we are able to meet the needs of those we serve and keep our promises, including achieving our financial outlook for colleagues and I very much look forward to another successful M.

10 CORDANIP resident and Chief Executive Officer Affordability will continue to be our number one focus in 2021. SHAREHOLDER LETTER leading the wayTaking robust action since the start of the COVID-19 pandemic. Removed cost as a barrier15 Protected customers from surprise bills and lowered prescription costs for the uninsured16 Expanded virtual care three times and increased on-demand mental health support partnerships17 Helped employers keep their workforce safe and supported18 Launched the Brave of Heart Fund in partnership with New York Life Foundation to support families of frontline health care workers19delivering growth with purpose62020 AT A GLANCE leading the wayTaking robust action since the start of the COVID-19 pandemic. Removed cost as a barrier15 Protected customers from surprise bills and lowered prescription costs for the uninsured16 Expanded virtual care three times and increased on-demand mental health support partnerships17 Helped employers keep their workforce safe and supported18 Launched the Brave of Heart Fund in partnership with New York Life Foundation to support families of frontline health care workers19delivering growth with purpose62020 AT A GLANCE2020 AT A GLANCE7delivering on our missionChampioning affordable, predictable and simple health value Saved patients and plans nearly $45B20 10% improved pharmacy spend for clients20 4% improved medical spend for our integrated clients21 Partnership + Innovation Expanded virtual care and behavioral networks.