Cigna posted a solid first quarter but the market wasn’t impressed. The health insurer beat on both earnings and revenue, lifted its full-year outlook, and still watched its stock drop.
CIGNA $CI Q1’26 EARNINGS HIGHLIGHTS
Adj. Revenue: $68.52B (Est. $66.24B)
; +5% y/y
— Wall St Engine (@wallstengine) April 30, 2026
Q1 adjusted EPS came in at $7.79, up from $6.74 a year ago and above the Wall Street consensus of $7.60. Revenue hit $68.5 billion, a 5% increase year-over-year, clearing the $66.3 billion estimate.
The company also nudged its full-year 2026 EPS guidance up to at least $30.35, a $0.10 increase from its previous forecast. That midpoint sits just ahead of the analyst consensus of $30.33.
Despite the numbers, the stock fell roughly 3% to around $283 in early trading.
Adjusted income from operations rose 12% to $2.1 billion, compared to $1.8 billion in Q1 2025. The gains were driven by Cigna Healthcare and Evernorth Health Services.
Cigna Healthcare’s pre-tax adjusted income from operations jumped 18% to $1.5 billion. Its medical care ratio improved to 79.8%, down from 82.2% in the year-ago quarter.
Evernorth reported adjusted revenues of $58.4 billion, up 9% year-over-year. Specialty and Care Services income climbed 20% to $1.1 billion.
The weak link was the pharmacy benefit manager side. TD Cowen’s Charles Rhyee called it the “only blemish” in an otherwise clean report, but noted it wasn’t a surprise given similar weakness at UnitedHealth and Elevance Health. He kept a Buy rating with a $338 price target.
Leerink Partners’ Whit Mayo held a Market Perform, writing that results “look fine” but that “not much jumps off the page as particularly surprising.”
Cigna has been reshaping its PBM business since last fall, moving toward a “rebate-free” model in response to regulatory pressure and public criticism over drug pricing practices.
In February, Cigna’s Express Scripts became the first of the three major PBMs to settle with the Federal Trade Commission over insulin pricing litigation. No liability was admitted, and the settlement aligned with the rebate-free model already announced.
Cigna is also heading into a leadership change. CEO David Cordani is retiring on July 1, with COO Brian Evanko stepping in as his replacement.
The combination of a business model transition, a CEO handoff, and a cautious analyst reaction helps explain why a beat-and-raise quarter still wasn’t enough to move the stock higher.
Cigna’s medical care ratio improvement and the organic growth in specialty businesses were the clearest positives from the quarter.
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