Cash Flow Statement

The cash flow statement provides information about a company cash receipts and cash payments during an accounting period, showing how these cash flows link the ending cash balance to the beginning balance shown on the company balance sheet.

The cash flow statement consists of three parts: cash flows provided by (used in) operating activities, cash flows provided by (used in) investing activities, and cash flows provided by (used in) financing activities.

Cigna Group, consolidated cash flow statement

US$ in millions

12 months ended:	Dec 31, 2023	Dec 31, 2022	Dec 31, 2021	Dec 31, 2020	Dec 31, 2019
Net income	5,372)	6,746)	5,415)	8,489)	5,120)
Depreciation and amortization	3,035)	2,937)	2,923)	2,802)	3,651)
Realized investment (gains) losses, net	78)	495)	(196)	(149)	(177)
Deferred income tax benefit	(1,659)	(480)	(220)	(386)	(313)
(Gain) loss on sale of businesses	1,499)	(1,662)	—)	(4,203)	—)
Debt extinguishment costs	—)	—)	141)	199)	2)
Accounts receivable, net	(1,663)	(2,237)	(2,843)	(1,496)	(713)
Inventories	(868)	(1,055)	(557)	(504)	149)
Reinsurance recoverable and Other assets	(539)	(38)	(656)	(77)	(519)
Insurance liabilities	584)	291)	967)	841)	575)
Pharmacy and other service costs payable	2,030)	1,760)	1,961)	2,891)	(192)
Accounts payable and Accrued expenses and other liabilities	3,481)	1,574)	(77)	1,346)	1,343)
Other, net	463)	325)	333)	597)	559)
Net changes in assets and liabilities, net of non-operating effects	3,488)	620)	(872)	3,598)	1,202)
Adjustments to reconcile net income to net cash provided by operating activities	6,441)	1,910)	1,776)	1,861)	4,365)
Net cash provided by operating activities	11,813)	8,656)	7,191)	10,350)	9,485)
Debt securities and equity securities	1,078)	1,744)	2,030)	2,283)	3,487)
Proceeds from investments sold	1,078)	1,744)	2,030)	2,283)	3,487)
Debt securities and equity securities	972)	1,327)	1,628)	1,519)	1,825)
Commercial mortgage loans	186)	98)	180)	19)	199)
Other sales, maturities and repayments, primarily short-term and other long-term investments	586)	1,039)	1,936)	1,575)	1,311)
Investment maturities and repayments	1,744)	2,464)	3,744)	3,113)	3,335)
Debt securities and equity securities	(4,334)	(2,756)	(3,553)	(4,765)	(4,282)
Commercial mortgage loans	(118)	(161)	(327)	(113)	(307)
Other, primarily short-term and other long-term investments	(1,205)	(1,563)	(2,554)	(1,924)	(1,753)
Investments purchased or originated	(5,657)	(4,480)	(6,434)	(6,802)	(6,342)
Property and equipment purchases, net	(1,573)	(1,295)	(1,154)	(1,094)	(1,050)
Acquisitions, net of cash acquired	(447)	—)	(1,833)	(139)	(153)
Divestitures, net of cash sold	13)	4,835)	(61)	5,592)	—)
Other, net	(332)	(170)	97)	23)	(11)
Net cash (used in) provided by investing activities	(5,174)	3,098)	(3,611)	2,976)	(734)
Deposits and interest credited to contractholder deposit funds	167)	164)	153)	1,023)	955)
Withdrawals and benefit payments from contractholder deposit funds	(223)	(220)	(168)	(979)	(1,097)
Net change in short-term debt	1,198)	(2,059)	975)	60)	(681)
Net proceeds on issuance of term loan	—)	—)	—)	1,398)	—)
Repayment of term loan	—)	—)	—)	(1,400)	—)
Payments for debt extinguishment	—)	—)	(136)	(212)	(3)
Repayment of long-term debt	(2,967)	(500)	(4,578)	(8,047)	(4,491)
Net proceeds on issuance of long-term debt	1,491)	—)	4,260)	3,465)	—)
Repurchase of common stock	(2,284)	(7,607)	(7,742)	(4,042)	(1,987)
Issuance of common stock	187)	389)	326)	376)	224)
Common stock dividend paid	(1,450)	(1,384)	(1,341)	(15)	(15)
Other, net	(413)	(23)	39)	(160)	(92)
Net cash used in financing activities	(4,294)	(11,240)	(8,212)	(8,533)	(7,187)
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash	16)	(86)	(65)	41)	(8)
Net increase (decrease) in cash, cash equivalents and restricted cash	2,361)	428)	(4,697)	4,834)	1,556)
Cash, cash equivalents and restricted cash, January 1	5,976)	5,548)	10,245)	5,411)	3,855)
Cash, cash equivalents and restricted cash, December 31	8,337)	5,976)	5,548)	10,245)	5,411)

Based on: 10-K (reporting date: 2023-12-31), 10-K (reporting date: 2022-12-31), 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31).

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Cash flow statement item	Description	The company
Net cash provided by operating activities	Amount of cash inflow (outflow) from operating activities, excluding discontinued operations. Operating activity cash flows include transactions, adjustments, and changes in value not defined as investing or financing activities.	Cigna Group net cash provided by operating activities increased from 2021 to 2022 and from 2022 to 2023.
Net cash (used in) provided by investing activities	Amount of cash inflow (outflow) of investing activities, excluding discontinued operations. Investing activity cash flows include making and collecting loans and acquiring and disposing of debt or equity instruments and property, plant, and equipment and other productive assets.	Cigna Group net cash (used in) provided by investing activities increased from 2021 to 2022 but then decreased significantly from 2022 to 2023.
Net cash used in financing activities	Amount of cash inflow (outflow) of financing activities, excluding discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit.	Cigna Group net cash used in financing activities decreased from 2021 to 2022 but then increased from 2022 to 2023 exceeding 2021 level.

Cigna Group (NYSE:CI)

Cash Flow Statement