Keith Gulledge Consultant Acumen Learning, LLC May 22, 2013

1. Cigna Q1-2013 Quarterly Conference Call Review and Follow-up from Building Business Acumen Class Keith Gulledge Consultant Acumen Learning, LLC May 22, 2013

2. Q1-2013–Earnings Call Review In conjunction with • Thank you for joining us! • Call will last approximately one hour. • Preparation: • 1) Listen to the Q1-2013 Earnings Call conducted on May 2, 2013 • 2) Fill out the Conference Call worksheet • 3) Print off any documents that would be helpful as a reference (Investor Relations webpage contains the Cigna quarterly and annual financial information) Keith Gulledge

3. 1st Quarter 2013 Earnings Call Review Notes • Transcript from the Cigna Earnings call located at:www.seekingalpha.comor www.morningstar.com • Note:My intent is to help us understand the numbers in the context of your overall Business Acumen training and the 5 Business Drivers. My role is not to editorialize or speculate about business decisions, the sufficiency of communications to investors, or other business matters. Our focus is to understand the quarterly earnings report, the highlights of the earnings call, and what Cigna’s financial results and 2013 outlook mean as related to the 5 Drivers and how Cigna makes money.

4. Agenda – 1 Hour • Introduction & Review 5 Drivers 3 min. • Key Messages & Financial Analysis 50 min. • Overview • Performance: Cash, Profit, Asset, Growth, People, other factors • Analyst Questions & Discussion • Outlook and Guidance for 2013 • Wrap up – Q&A 7 min. These and other workshop slides and materials available for .PDF or .PPT download at: www.5-drivers.com/behealthy

5. Earnings Call Participants • David M. Cordani—Cigna President and CEO • Ralph J. Nicoletti—Cigna CFO and Executive VP • Edwin J. (“Ted”) Detrick—Cigna VP of Investor Relations • 13 analysts from: • Goldman Sachs • JPMorgan Chase • Bank of America Merrill Lynch • Barclays Capital • Cowen and Company • Dowling & Partners Securities • Wells Fargo Securities • Deutsche Bank • Jefferies & Company • Credit Suisse AG • Wedbush Securities • Susquehanna Financial Group • USB Investment Bank

6. 5 Key Drivers: Review • Growth is a MEASURE and a STRATEGY • 2 Types of Growth: • Organic & Inorganic • Importance: • Investors expect • Employees energized • Customers attracted • Executives measured Cash Balance and Cash Flow(NOT same as Profit) Employees & Customers, Clients • Why is CASH important? • Invest back into the business • Pay Overhead Costs • Acquisitions • Capital Expenditures • Return value to Shareholders • Dividend payments • Stock Repurchases CEO’s #1 Job: Grow shareholder value MEET, EXCEED, then ANTICIPATE Customer Needs Asset Balance • Profit = Revenue ▬ • Expense • Indicators: • MCR • Operating Profit • Net Margin • EPS • Strength • Liquidity • Equity to Assets Profitis a calculation per GAAP for financial and tax reporting to match Revenue and Expense • Utilization • ROA • ROE • ROI

7. Overview of Earnings Call • 13analysts asked @ 28questions • Dominant questions and discussion: • PROFITABLE GROWTHdriven by • PEOPLE (Customers, Physicians, Markets) David Cordani followed by Ralph Nicoletti—Q1-2013 results and operations, plus Full Year 2013 outlook. Breakdown of analysts’ questions by topics & subjects (several questions addressed more than one Driver): • 13 or 30%PROFIT – always in context of GROWTH • 10 or 23%GROWTH STRATEGY – context of PROFITS & CUSTOMERS, including questions around Segment growth, ASO & CAC • 15 or 34% PEOPLE – Customers & Physicians, market segments, ASO, Medicare Advantage membership • 4 or 9%ASSETS – A few questions, other than about Capital deployment • 2 or 4%CASH – Stock buy-back, capital deployment, investments

8. 5 Driver Integration: Discussion • CASHas an ASSETusually discussed in context of reserves,capital deployment or investment for future GROWTH • PEOPLE include customers, clients, providers, andmarket segments—always in context of driving revenue and containing costs for PROFITABLE GROWTH • ASSETS are referenced as investments,reserves, or portfolio of products and services, or units such as HealthSpring—and always in the context of future contribution to revenueand EPSGROWTH • PROFITS discussed in context of revenue (rates) and costcategories, especially MCR and operating expense trends, always with respect to past and future GROWTH of revenue, profits and EPS Dominant Drivers: GROWTH of PROFITS, CUSTOMERS

9. Key Messages: Outline to Analysts • Review of key Q1-2013 results • How Cigna’s strategy continues to create value for our clients, customers and shareholders • How Cigna is positioned to continue to grow going forward: • Global mix of business • Differentiated capabilities • Emphasis on Customers • Outlook and expectations for balance of 2013 and beyond ─ David Cordani, CEO—Q1-2013 Earnings Call

10. Key Messages: Q1-2013 Summary “We are pleased with our first quarter results, which demonstrate a strong start to the year for Cigna. Our performance was a direct result of continued effective execution of our strategy and the strength of our diverse portfolio of businesses. Our first quarter performance was driven by our commercial health care and global supplemental businesses.” ─ David Cordani, CEO—Q1-2013 Earnings Call

11. Overview of Q1-2013 • Cigna Q1-2013 and Past Performance • Revenues 21%to $8.2 billion • Premiums & fees 20%to $7.3 billion • Adjusted Income from Operations per share 38% to $1.72 ($497 million total) • Last 3 calendar years compounded Growth: 17%Revenue and 15% EPS • Global Medical Customer base by 277,000 people, or 2%to 14.3 million Customers over year-end 2012 (up 3.3% and 457,000 Customers Y/Y) • Cigna 2013 Outlook—Increased • Adjusted Income from Operations— • $1.74 to $1.87 billion or $6.00 to $6.45 per share (increase of $0.15/share) • Update on Key Recent Events • Transaction with Berkshire Hathaway to exit Run-off Reinsurance business • Lead sponsor of Global Healthy Workplace Summit—April in London, over 30 countries participated • CDHP customer base increased by 26% in 2012—clients lower cost 13% yr. 1

12. Highlights of Q1-2013 Commercial Health Care: Growing in target markets through (1) customer retention; (2) expanding existing customer relationships; (3) adding new customers. Delivered outstanding high quality medical outcomes and competitively attractive medical costs Global Supplemental Benefits: “Healthy increase in revenue and earnings, solid customer growth, effective cost management, contributions from recent acquisitions.” Seniors: Performed well, value of physician partnerships Disability and Life: Challenging economic and interest rate environment. Individuals: Taiwan launched dementia products; Korea, critical illness programs; Turkey, products to help individuals to save better for health care & retirement needs; myCigna app for mobile research

13. Highlights of Q1-2013—cont’d. Collaborative Accountable Care: 58 CACs cover 24 states; 10 new CACs in Q1. HealthSpring physician engagement strategies create “sustainable model” to enhance patient experience. Programs now support 1 million customers in commercial and Senior. Collaborating with over 23,000 doctors.

14. Summary & Outlook: 2013 and Beyond 2014: Finalization of CMS guidance for Medicare Advantage will create significant change and cause “customer, market and earnings disruptions.” Will continue our Go Deep, Go Global and Go Individual strategy introduced in 2009. Remain grounded in customer centricity and our differentiated value proposition. Longer term: Target EPS growth over next 3-5 years of 10-13% per year.

15. Perspective on Future Opportunities Companies and individuals will continue to demand health, well-being and security solutions that are high quality and affordable. Will see ongoing changes in the way customers access health care and wellness solutions— evolving individual, employer and government-based channels, and emerging public and private exchange models. Needs of customers will keep evolving—aging population, more prevalent chronic diseases, growing middle class, customers becoming more informed and engaged. Employers will continue to play a meaningful role in health and productivity of employees. CDHP solutions continue to grow and deliver attractive returns.

16. Segment Review: Q1-2013 • Global Health Care: 80% of Rev. fr. Ongoing Ops. • Premiums & fees up 20% to $5.8 billion • Adj. Earnings fr. Ops: up 44% to $427 million—strong ASO customer growth • 14.3 million global Medical customers, up 2% or 277,000 customers • Medical costs: Trends among lowest in industry. Commercial guaranteed MCR 77.6% (or 80.3% excluding prior year reserved development) • 85% of US Commercial customers are ASO—trend continues • Seniors medical costs: MCR for Medicare Advantage—84.3% (or 84.7% excluding prior year reserve development)—flu impact • Operating Expense ratio:20.7% decrease, but will not continue • Overall a very strong quarter in Global Health Care

17. Segment Review: Q1-2013 • Global Supplemental Benefits • Premiums & feesup36%—strong customer retention and new customer growth, Great American Supplemental Benefits acquisition • Adj. Earnings fr. Ops: $55 million,up28% • Continue to invest in products, distribution, geographic expansion • Group Disability and Life—challenging economic environment • Premiums & fees up 12% to $858 million • Adj. Earnings fr. Ops:Down 28% to $49 million. Unfavorable claims experience in disability business • Remaining Operations • Run-off Reinsurance, Other and Corporate: $34 million loss after tax • Performance consistent with expectations

18. Key Messages: CASH – Q1-2013 “We’ve had a very strong start to the year, demonstrating the strong fundamentals of our businesses as we continue to build upon our excellent rack record. “…Overall, we continue to have good financial flexibility. Our subsidiaries remain well capitalized and are generating significant free cash flow to the parent, with strong return on capital in each of our ongoing businesses.” ─ Ralph Nicoletti, CFO —Q1-2013 Earnings Call

19. CASH: Capital Management Report Q1-2013 Capital Deployment & 2013 Outlook Q1-2013 ending Parent company Cash: $620 M Repurchased 3.9 mill shares of stock thru 5-1-13: $250 M Parent company Cash—expected end of 2013:$500 M Expect 2013 Cash for deployment—rest of 2013:$1.0 to $1.1 B Reinsurance premium paid to Berkshire Hathaway: $1.5 B

20. CASH: Discussion Topics • Cash available to fuel M&A Growth—$1.0 to $1.1 billion • Cash used to pay Berkshire Hathaway to exit Run-off Reinsurance business—$1.5 billion • Stock buy-back activity: $250 million through May 1 • Capital management priorities remain unchanged: operations, stock buy-back, opportunistic M&A

21. CASH Performance Consolidated from all Segments GROWTH 1 Special Item is cash paid to Berkshire Hathaway to effectively exit the Run-off Reinsurance business.

22. PROFIT: Discussion Topics • Medicare rate impact for 2014; effect of risk adjustment • model changes on HealthSpring, specific markets—risk score model—Disruption. Impact 4-5%, excluding industry tax. Market variability. • Cigna capabilities:(1) Comprehensive benefit offerings; (2) physician partnering • Ability to grow EPS at 10% to 13% per year. Disruption in Medicare rate environment. “Time will tell.” To early to see 2014. • Benefit cuts vs. margin reductions—flow through to capitated physician groups. Impact on MA business. Risk coding indicates level of physician engagement, active care coordination. Risk coding can be higher—CAC organization, more actively managed population. • Operating Exp. Ratio—to improve at least 50 bps from 22.6% in 2012. Continue to make strategic investments, technology, productivity gains. • MA is about 15% of company earnings • Cost trends expected 6%-7%; utilization, see no real change. Will move MLR up on 2014 to be within new MLR guidelines

23. PROFIT: Discussion Topics—cont’d. • Impact on Profit from the exchanges • Effect of Medicaid, impact of federal subsidies on markets at 250% of federal poverty level vs. 150% • Impact of sequestration on guidance—already considered. • Discussion of Q1 special items, impact on profit; Disability business, impact of regulatory review re claims handling process. • Details on prior year development (PYD) on Q1 margins

24. PROFIT Performance GROWTH Earnings per Share (EPS) are diluted

25. ASSETS: Discussion Topics PBM discussion—business is performing well, profitable. Evaluating alternatives (not discussed) presented by HealthSpring. Formulate plays by mid-year 2013. Balance Sheet discussion—real estate portfolio. Focus on matching assets with liabilities and durations. Good at creating sustainable returns. Questions concerning business units, performance.

26. ASSETS Performance GROWTH 1 Q1 2013 Liabilities includes redeemable non-controlling interests 1 2 Q1 Adj. Inc.-Op. is annualized for ROE calculation: Q1-2012 = $359 Q1-2013 = $497 2 Equity Ratio = Equity ÷ Assets ROE uses Adj. Inc. fr. Operations When Analysts talk about Cigna’s Assets, they are usually referring to the business portfolio of products and services, or to the business units, such as HealthSpring.

27. GROWTH • Virtually every question, statement or comment was made in the context and consideration of its possible impact on PROFITand GROWTH, including future conditions.

28. GROWTH: Discussion Topics Increase conversions to ASO, particularly Select Segment; continued trend of the last 3-4 years. Cigna is @85% ASO customers. Membership Growth and margins for MA: “Bias towards sustainability.” Balance margin with Growth. Disruptive environment. 2014 and 2015 will have “both organic and inorganic growth opportunities.” HealthSpring. Guidance provided includes consideration of “headwinds”—including sequestration impact and effect of prior year development Certain investments delayed from Q1 until later in the year Outlook for 2014— “continue to deliver competitively attractive top-line and bottom-line results.” Success of US Commercial, Regional and Select Segments, can drive Global individual business. Strength of cash flow and financial flexibility and exit from Reinsurance business. Outlook for US Group Disability business, Q1 negative claims experience.

29. GROWTH: Discussion Topics—cont’d. M&A opportunities—Berkshire transaction improves financial flexibility; $1.0 to $1.1 billion cash; CMS rate environment creates disruption in 2014-2015. Can use HealthSpring model as M&A integration platform. But also organic Growth commitment. Plan of entering 2-3 new markets per year. Prioritize these opportunities. 2014 rate environment changes the profile. Our physician partnering model presents an “opportunity for sustainability.” Medicaid growth strategy: Not a big part of our business, not a strategic priority. Go Deep markets with opportunity for differentiated value is in care coordination for the high-risk population. Duel eligibles.Texas, Illinois as example, have physician partnering. Impact and pace of Growth from the exchanges. Change and disruption. CAC base to build profitable operations in new markets

30. PEOPLE: Discussion Topics Physician engagement model—working with physicians in transparent, collaborative way to improve care quality, reduce costs Cigna participation in exchanges beginning 2014. Been running pilots for last three years. Bias to participate—limited number or markets. Think MSAs, not just states. Need CAC relationships. Health care is “extraordinarily local.” Cigna does not have an “under 50 life employer block of business to protect” nor material individual block of business. Look at exchanges through “a fresh lens.” Rate negotiations with providers. View on exchanges for large- and mid-size employees—Cigna participation, threat to ASO business. Purposes of exchanges. Cigna is experienced in environment of choice.

31. PEOPLE: Discussion Topics—Cont’d. Medicare Advantage and Medicare Supplement business— effect of competitive disruption. Different demographics and geographic differences in MA and MedSup buyers. “Time will tell” on 2014 rate impact Studies: Seniors/MA participants are “highly satisfied” but have slightly lower income. Will take time to determine how market responds, if a shift to fee-for-service and buying a MedSup makes sense. Cigna should have less than average disruption due to deep physician relationships in key geographies. Strength in specific international markets—Global Supplemental business “performing extremely well.” Continued investments in Turkey, India. Global Health Care business performed “in line with our expectations.” Will “import into US” distribution innovation from individual international experience: channels, telemarketing, affinity partners

32. GROWTH & PEOPLE Performance by SegmentsQ1-2012 vs. Q1-2013 Policies & Lives in 000’s Formerly HEALTH CARE Medical customers up by 457,000 PEOPLE Formerly INTERNA-TIONAL PEOPLE Formerly DISABILITY & LIFE Benefits + Op. Exp. UP 16% PEOPLE * Adjusted Margin After Tax = Adj. Inc. fr. Ops After Tax ÷ Segment Revenues

33. EXTERNAL FACTORS: Discussion Topics • Administration proposals around MedSup, are working proactively with Washington “on both sides of the aisle.” Ramifications: Too early to predict. • Impact of ACA, exchanges, CMS rate disruption in 2014

34. 2013 Outlook: Revised upward from Q4-2012 Black titles = same Outlook Blue titles = Revised • Revenue Growth: 8% to 12% • Adjusted Income from Operations: $1.74 B to $1.87 B or $6.00 to $6.45 EPS (previous, $1.7 B to 1.83 B; $5.85 to $6.30 EPS, UP $0.15/sh.) • Global Health Care: Earnings:$1.47 B to $1.56 B (previous $1.43 B to $1.52 B). Medical Customers 1% to 2% • Medical Costs—US Commercial 6% to 7% (utilization ) • MCR—US Commercial guaranteed: 82.5% to 83.5% 100 bps (previous, 83.5% to 84.5%) • Senior Medicare Advantage MCR—82% to 83% • Operating Expense Ratio: 50 bps to 22.1% from 22.6% in 2012 • Global Supplemental Benefits: Strong top line growth; Earnings $160-$180 million. • Group Disability and Life: Earnings $270 to 290 million.

35. Summary: David Cordani “…We are pleased with our first quarter results, which demonstrated a strong start to the year for Cigna. Our performance was the direct result of the effective execution of our strategy and the strength of our diverse portfolio of businesses. “…Cigna’s sustained strategic investments and continued expansion of our portfolio of employer, individual and Senior solutions capabilities positions us to continue to serve our customers and clients in this dynamic global environment.” David Cordani, CEO—Q1-2013 Earnings Call

36. Encouragement & Challenge Thank you for joining the Business Acumen Earnings Call review. • My encouragement and challenge to continue to sharpen your Business Acumen: • Quarterly review of Cigna’s financial performance— Investor Relations section of website, financial information, press release & other materials provided • Listen to quarterly Earnings Call or review transcript • Quarterly reviews of competitors, industry, economy • Continue to watch stock performance thru 2013 • Implement Action Items to drive business value • Teach your teams QUESTIONS & COMMENTS?