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The Cigna Group
Cigna sells health insurance and runs a pharmacy benefits business that manages drug costs for employers and insurers.
Cigna is a health insurance company, but a big part of what it actually does is handle other people's health care money. It sells medical plans to employers who want to cover their workers, to individuals buying coverage on their own, and to insurers who need to cover their members. It also runs a huge pharmacy benefits management business, which is the behind-the-scenes operation that negotiates drug prices with pharmacies and drugmakers on behalf of employers and health plans.
That pharmacy business, called Evernorth, is the piece most people never see. When you fill a prescription, the drugstore sends the bill through a middleman that checks the price, pays the pharmacy, and bills your health plan. Evernorth is one of the largest of those middlemen in the United States, processing prescriptions for millions of people and taking a small cut along the way. Health plans hire it because negotiating drug prices is complicated, and a big buyer can usually get better deals than a small one. On the insurance side, Cigna focuses heavily on employers rather than selling individual policies to consumers. It sells plans that cover doctor visits, hospital stays, and prescriptions, and it makes money when the premiums it collects exceed what it pays out in medical claims. That spread is thinner than it sounds, and it can swing wildly when lots of people get sick at once. Cigna also sells supplemental products like dental, vision, and disability coverage, and it has a growing business serving people who get government-funded coverage. The company has been reshaping itself. It sold its Medicare Advantage business — the privately run version of government health coverage for seniors — to Health Care Service Corporation in a deal that closed in 2025, choosing to focus on employers, pharmacy services, and its international operations instead. Cigna also owns a business that sells health coverage to people living abroad and to international employers.
The big risk hanging over Cigna is regulation. Pharmacy benefit managers have become a favorite target for politicians who argue they drive up drug costs rather than lower them, and new rules could squeeze how those businesses operate. Cigna's size helps it negotiate better deals, which is its main edge over smaller rivals, but it also makes it a visible target. In short, Cigna sits in the middle of the American health care money flow, collecting fees and premiums while trying to keep drug and medical costs under control.
Saved answer · last researched 12 Nov 2026