Cigna CAP Report

COMMITMENT TO

BETTER

Total Health Insight GEN Digital PanTexas Deterrance, LLC. November 26, 2024 April 28, 2026 POWERED BY

CONSULTATIVE

ANALYTICS

Cigna Team Barbara Eckert Vice President, National Account Executive Megan Baggett Account Manager Ozzie Khan, MD Medical Executive, National Accounts Amanda Watkins, RN Nurse Executive, National Accounts Eddie Bradford, MBA Senior Informatics Consultant, Client Reporting

2

Agenda

Our Mission

Insights

Report Parameters

1. A Better Kind of Service

• Current period reflects claims incurred between Jan 2025 and Dec 2025, paid through Feb 2026 (incl.

4% completion factor)

2. Executive Summary

To improve the health and vitality of those we serve

3. Solutions 4. Multi-Year Trend 5. Product Side by Side

6. Total Health Insight o

• Base period reflects claims incurred between Jan 2024 and Dec 2024, paid through Feb 2026

• High-cost claimant threshold of $100k was used for this analysis

Medical & Pharmacy

7. Condition Care 8. Population Health

• Norm represents Cigna’s book of business for Open Access Plus (OAP) in Texas – 944K members

9. Virtual Care

Our Commitments to Better 1. Easier Access to Care - We commit to address

the challenges customers and patients face by making our processes simpler, easier, and faster.

2. Better Support - We commit to enhanced

support and resources to navigate the health care system with greater ease and peace of mind.

3. Better Value - We will provide better value for our customers and patients.

10. Appendix Note: Total Health Information is on an incurred basis and is different from the paid data that is used in the annual “rate setting”.

4. Accountability - We will stand behind our commitments to our customers and patients.

5. Transparency - We commit to provide public

information on how we are continuously improving to serve our customers better.

3

Leading through clinical innovation Designed for one, scaled for all Smarter identification

Accelerated engagement

Identify risk early

Act quickly and precisely

Streamlined care delivery

Models and data • Artificial intelligence (AI) across 200 + predictive models

Targeted action • AI-enabled case management with enhanced next-best-action guidance

Reduce friction • 17% reduction in prior authorizations

• Near real-time insights using prior-day claims data

• Targeted outreach to high-risk and high-cost Populations

• Faster approvals: Minutes vs. days

What it enables • Earlier detection of conditions and disease progression (e.g., breast cancer: 55 days sooner) • Rapidly pinpoint cost and risk drivers by market, site, and workforce • Flag emerging high-cost claimants and rising-risk members early

Earlier identification

Deliver care seamlessly

• Rapid 24 – 48 Hour post-ED followup for ambulatory-sensitive conditions

Improve access • EHR integration + value-based alignment

Personalized support • Close care gaps through targeted engagement campaigns

• Dedicated advocacy pathways for complex and life-altering diagnoses

• Hybrid on-site + virtual care model

Faster action

Better outcomes

• Integrated pharmacy + EHR point of care approvals

Lower total cost

4 Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

From high-cost reporting to predictive risk identification ​Comparison to prior 12 months Prior 12 Months

Count: 17 Total Dollars for Claimants over $500K $19.5M

Continuing: At-Risk Over $500K

Count: 3-5 Total Estimated Dollars in 2026 $3.5M - $6.0M

Emerging: At-Risk Over $500K

Count: 3-9 Total Estimated Dollars in 2026 $3.6M - $12.5M

​Forward-looking, member-level reporting

Reasons for drops: • Terminations • Concluded events/risk

• Future claims not expected to exceed $500K

High dollar prescription, stem cell transplant Gene therapy authorization, high dollar prescription

Bridges historical experience with forward-looking risk Enabling planning based on where cost is heading, not just where it has occurred Integrated predictive modeling and clinical validation Combines predictive analytics with in-depth, clinician validation to deliver more accurate, actionable cost and risk forecasts

• Predicts future high-cost claimants at the member level before costs materialize, using integrated claims, authorization, and emerging risk signals • Identifies individuals at risk of exceeding cost thresholds within 12 months, including chronic progression, ongoing utilization, and emerging high-cost events across services

5

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Executive Summary Cost and Utilization Trends

Chronic Condition Management

Key Condition Focus Areas

Overall • Membership rose by 2.8% or by 349 members • H S A plan had the biggest spike in membership increasing by 287 members • Total PMPM spend rose by 29% +$26.1M year over year • Well visits and preventive care rates held steady and were above and equivalent to norms, respectively

Overall • Your Health First is our chronic condition coaching program designed to help members better manage ongoing health conditions through personalized coaching, education, and digital engagement • Chronic members percentage increased from 43% to 46% and are above norm of 41% • Chronic members percentage of spend rose from 71% to 74% and is below norm of 77%

Musculoskeletal • Prevalence 35% • Total spend $23.9M • Joints, Muscle/Connective Tissue, and Fractures/Dislocations make of 68% of spend • Surgical is the top Outpatient Service category followed by Emergency Room

Non-Catastrophic Medical • PMPM spend rose by 22.2% or up $15.5M • Non-Catastrophic contributed 16.8% to the overall 29% trend • Top trend contributors: Musculoskeletal, Gastrointestinal, and Neoplasms

Engagement • 4,798 members were identified with a chronic condition down from 5,047 in 2024 • 45% of chronic members were engaged down from 46% in 2024 compared norm at 51% • Top engagement modalities: Preventive Care and Alert with Action

Neoplasms • Prevalence 3.3% • Total spend $10.6M • Cancer Screening compliance rates are below norm for Cervical and Colorectal screenings • Top Cancers by Spend: Breast, Prostate, and Skin

Catastrophic Medical • PMPM Spend rose by 49.6%, up +$10.6M • Catastrophic claimants contributed 12.2% to overall trend of 29% • Claimants rose from 12 in 2024 to 20 in 2025 • Average cost per claimant rose from $249K to $280K and is above norm of $259K

Chronic Conditions • Top Chronic Conditions: Low Back Pain, Depression and Diabetes • 82% (16) of catastrophic claimants has a chronic condition • Hypertension, Obesity, and Disease of the Thyroid were the top chronic conditions for catastrophic claimants

Cardiodiabesity • 32% (4,103) of members have 1 to 3 of the associated conditions • Average age of these members is 47 years and 51% are males • Cost for these members is 2.5x higher than for those without these conditions

6

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Solutions

In Process – Need confirmation of Solutions during prep call

• • • • • •

Well Visits Cancer Screenings Immunizations One Guide Customer Navigation Tool Personify Well Being Solution Paytient

Chronic Care • • • • •

Available at renewal

Women’s Health

Preventive Care & Education • • • • • •

Currently in place

Cigna Care Designated OBGYN Know Your Lemons Partnership Virtual Women’s Health Clinic (Visana) Case Management: Complex Gynecology Healthy Pregnancies, Healthy Babies Fertility Benefits

Condition Care •

Your Health First Lifestyle Management Program Cancer Care Support Program Omada Diabetes Prevention Omada Complete

AIRROSTI, ASH Care, and Joint Academy

Whole Person Care • • • • •

Education, Tools & Awareness MDLIVE Behavioral Health Nutritional Counseling Supplemental Health

• • •

Hello Fresh & Food Smart Preferred Lab Well-Being Strategist

7

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Multi-Year Trend Average Annual Trend, 2019-2025 Average Annual Trend $686

$494

$532 $472

$470

$469

$453

Total:

5.6%

Non Catastrophic:

8.2%

$490

$401

$306

$285

$305

$309

$315

$188

$185

$167

$160

$138

$131

$196

$0

$0

$0

$0

$0

$0

$0

2019

2020

2021

2022

2023

2024

2025

Catastrophic:

0.7%

8.5

MEDICAL COST TREND1

7.5

Anthem®

6.5

Aetna®

5.5

5.6%

United Healthcare®

2

4.5%

4

4.5

5.5%

3

4.3%

5

Major industry competitors

Cigna Healthcare

Cigna Healthcare® 3.5

2.5 2010

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2022

2023

2024

1. The 2010–2019 data is based on Cigna Healthcare and top three national competitors’ 2010–2019 analyst calls – publicly available information. Actual or midpoint of reported range used. 2. 2025 Segal Health Plan Cost Trend Survey Report. Medical trend results for 2020–2023, represented as a 4-year average due to COVID related volatility. 3. Cigna Healthcare U.S. Commercial book of business medical cost trend results 2020–2023, represented as a 4-year average due to COVID related volatility.

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

8

Product Side by Side Overview Select

HSA

Core

OAP, Texas

Total

2024 (Base)

2025 (Current)

2024 (Base)

2025 (Current)

2024 (Base)

2025 (Current)

average employees average members member average age total demographic factor non-users membership as % of total Membership % Change

3,083 9,058 32.4 0.83 8.0% 72.2%

3,063 9,102 32.5 0.86 7.0% 70.5% 0.5%

922 2,513 29.2 0.72 17.0% 20.0%

1,037 2,800 29.2 0.74 17.0% 21.7% 11.4%

384 982 29.5 0.72 14.0% 7.8%

384 1,002 29.3 0.75 12.0% 7.8% 2.0%

4,388 12,554 31.5 0.80 10.0% 100.0%

4,483 12,903 31.5 0.82 10.0% 100.0% 2.8%

medical PMPM spend pharmacy PMPM spend total PMPM spend cat claimants/k cat PMPM spend (Med+Rx) Total Plan Spend plan spend as % of total Trend Contribution

$592 $0 $592 6.5 $154 $64,351,293 80.3%

$776 $0 $776 9.1 $233 $84,804,790 79.8% 22.7%

$349 $0 $349 2.8 $69 $10,522,936 13.1%

$458 $0 $458 5.4 $112 $15,377,712 14.5% 5.5%

$445 $0 $445 7.1 $93 $5,243,291 6.5%

$503 $0 $503 6.0 $99 $6,042,541 5.7% 0.8%

$532 $0 $532 5.8 $132 $80,123,645 100.0%

$686 $0 $686 8.1 $197 $106,217,496 100.0% 29.0%

$545 $0 $545 7.4 $161

admits/k average LOS outpatient surgeries/k urgent care/k emergency room/k steerable ER/k pcp vists/k specialist visits/k pcp to spc ratio

58.1 4.9 226.2 43.1 236.8 32.0 3,777.0 2,344.6 1.6

65.4 4.8 233.3 44.3 264.4 31.6 3,955.5 2,376.7 1.7

35.0 4.2 135.7 29.8 150.0 21.1 2,571.9 1,561.9 1.6

35.6 3.6 139.4 33.3 154.4 11.3 2,646.1 1,620.9 1.6

68.2 2.5 139.5 21.4 233.1 33.6 3,007.9 1,719.2 1.7

60.2 3.1 144.2 40.9 220.9 22.5 3,373.2 1,583.9 2.1

54.2 4.6 201.3 38.7 219.1 30.0 3,475.6 2,139.0 1.6

58.6 4.5 206.0 41.7 237.1 26.5 3,626.2 2,151.1 1.7

48.0 5.2 121.5 252.2 237.5 40.0 2,081.7 1,413.4 1.5

Engagement

chronic % of population chronic % of cost well visit completion rate preventive care utilization gaps in care compliance breast cancer screening rate cervical cancer screening rate colorectal cancer screening rate

47.0% 73.8% 50.9% 57.0% 79.3% NA NA NA

50.6% 77.9% 51.5% 57.4% 79.3% 72.0% 56.0% 44.0%

30.4% 57.5% 49.1% 53.7% 76.1% NA NA NA

32.6% 61.8% 47.0% 51.9% 75.5% 68.0% 61.0% 41.0%

36.1% 55.2% 45.1% 51.2% 77.0% NA NA NA

37.7% 55.6% 45.8% 50.9% 75.5% 69.0% 58.0% 33.0%

42.8% 70.7% 50.1% 55.9% 78.6% NA NA NA

45.7% 74.3% 50.0% 55.7% 78.3% 71.0% 57.0% 43.0%

41.1% 76.6% 48.3% 56.0% 76.6% 66.0% 58.0% 47.0%

Pregnancy

vaginal deliveries/k c-section rate/k

9.8 2.9

10.5 3.6

7.6 3.2

6.7 2.4

10.2 1.0

12.0 6.6

9.4 2.8

9.8 3.6

6.8 4.2

Membership

Spend

Key Utilization

2024 (Base) 2025 (Current)

Norm

33.0 0.84 17.0%

9

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Total Health Insight Overview 12,903 Members;

2.8%



Contract Size: 2.9

(Norm: 2.1)

(Norm: 50% M / 50% F )

51% M / 49% F

(Norm: 33.0)

Avg Age: 31.5

Drivers of Trend

Costs & Trend Non-Catastrophic 22.3%

Total Medical 29.0%





$489 PMPM $386 (Norm)

$686 PMPM $545 (Norm)

Catastrophic $197 PMPM

49.1%



Non-Catastrophic Medical Trend: 22.2% Trend Contribution: 16.8%

Trend 29.0%

Catastrophic Medical Trend: 49.6% Trend Contribution: 12.2%

$159 (Norm)

Insights Medical Plan Spend Current: $106.2 M| Base: $80.1 M • Top 3 diagnostic groups accounted for 46% of medical spend:

Plan Spend by Category $500

• Musculoskeletal, Neoplasms, and Neurological Medical Specialty Pharmacy Current: $6.1 M| Base: $6.0 M • Top 3 therapeutic classes accounted for 70% of medical pharmacy spend: • Cancer, Multiple Sclerosis, RA/Psoriasis/Crohn’s

Catastrophic Claimants (> $100K) Current: 104 | Base: 73 Cost Per Claimant: Current: $280K| Base: $249K| Norm: $259K Contribution Strategy Check: Spouse to Emp Ratio – 2025: 1.4x, 2024: 1.3x, Norm: 1.3x Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

$0

Base Current Norm Trend Contrib

Inp $38 $52 $44

OP $151 $214 $149

Prof $155 $161 $128

Other $57 $62 $65

CAT $132 $197 $159

2.8%

11.9%

1.1%

1.1%

12.2%

IP – inpatient facility; OP – outpatient facility; Prof – provider services; Other – transportation, supplies, specialty medications, durable medical equipment; Cat – catastrophic care; Rx - pharmacy

10

Levers of Trend PanTexas Deterrance Achieved a FY 2025 Medical Cost Trend of 29% Utilization (Change in Volume of Goods) Unit Cost (Change in Cost of Goods)

Service Mix (Change in Basket of Goods) Demographics (Change in Population) Geography (Change in Location)

Unit Cost

Utilization +3.5%

+

+1.5%

Service Mix +

+23.2%

Demographics

Geography

-0.3%

+0.0%

+

+

Trend =

+29.0%

Medical trend result of 29% driven by a 23% service mix trend and an increase in utilization of 3.5% and unit cost increase of 1.5% Medical trend was influenced - by a decrease of -0.3% in demographic risk

Geographic Index Base Current Trend 1.11 1.11 0.0%

Geographic Index

Demographic Index *Demographic risk factor based on age and gender

* Cigna’s relative market index

Demographic Index

Impact to Demographics Age Impact: (0.004) Gender Impact: 0.000 Change: (0.003)

Base 1.0610

Current 1.0579

% Change -0.3%

Change in age distribution decreased the demographic Index by -0.3%

Change in population location distribution (state) contributed 0.0% to the overall medical cost trend result

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Top 5 States

Index

Percent of Population Base

Current 99.2% 99.2%

Texas

1.11

Oklahoma

1.08

0.1% 0.1%

California

1.04

0.0% 0.1%

Colorado

0.98

0.1% 0.1%

Florida

1.05

0.1% 0.1%

11 11

Medical Overview What is driving medical trend?

Routine Care Category

PMPM

Trend Contribution

$287

7.6%

Routine Care

Non-catastrophic trend contribution $202

9.2%

Unavoidable Care

PMPM

Trend Contribution

Office Visits

$67

0.8%

Other OP Facility

$31

0.0%

Other Professional

$86

1.9%

Preventive Care

$39

1.6%

Routine Diagnostic

$19

0.0%

Other

$46

3.4%

$287

7.6%

Category

PMPM

Trend Contribution

Maternity

$25

1.4%

Newborn

$9

0.6%

Non-Steerable ER

$72

4.3%

Inpatient (Non-Cat)

$34

1.8%

Total Routine Care

Unavoidable Care

$197

$686

12.2%

29.0%

Catastrophic Medical

Total Medical

Other Medical (Non-Cat)

$62

1.0%

Total Unavoidable Care

$202

9.2%

What were the top diagnostic trend contributors? (All Claimants)

Clinical Savings - $3.9M 3.7% of medical spend $316K 9.8%

3.5% 3.3%

Inpatient UM

Musculoskeletal

Neoplasms

$1.5M

$856K

Case Management

Circulatory

Outpatient UM 2.7% 1.6% -0.4%

Gastrointestinal

Other Medical Cost Mgmt

Pregnancy, Childbirth Infectious/Parasitic

$500K Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

$783K

Chronic Condition Coaching 12

Clinical Management

Insight-driven customer advocacy with clinical coordination Inpatient Utilization Management

Case Management

Total Medical Cost

Avoided Events

Avoided Events

Current:757 | Base: 690

Current:440 | Base: 335

Savings

Savings

Current: $727K | Base: $783K

Current: $499K | Base: $409K

Members Engaged

Events Current: 51 | Base: 74

Current: 242 | Base: 271

Savings

Savings

Current: $316K | Base: $548K

Current: $856K | Base: $1.3M

Event Summary • Admission avoided: 15 • Decertified Days: 6 • Bed Day Intensity Management: 30 • Readmission Avoided: 1

Case Management Summary • Total cases engaged/managed: 254 • Top 3 category managed: Medical Injectable Steerage, Complex, and NICU

Inpatient Management 7%

Outpatient Utilization Management

Savings are derived from programs including home health care, diagnostic imaging, medical injectables, durable medical equipment, and site of care.

Outpatient Management

Case Management

3% 10%

Complex

49%

NICU

Other

MSK Pain Mgmt

8%

Radiation Therapy

CT

Cardiology Mgmt

Medical Injectables Renal Case Mgmt.

Readmissions Avoided

4%

MRI

20% 43%

15%

Decertified Days

77%

5% 5%

Medical Injectable Redirection

13% Bed Day Intensity Mgmt.

Total Medical Cost

5% 2%1%

6%

Avoided Admits

Top Categories • MSK Pain Management • Radiation Therapy • Cardiology Mgmt.

PET DME

All Other 21%

Chiropractic Services 17%

62%

Physical Therapy Genetic Testing

29%

13

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Catastrophic Summary $100,000 Threshold Overview

Conditions

Costs

Engagement

104 claimants (Base: 73)

82% have a chronic condition

$280K average cost per individual

90% overall engagement rate

• Average Age: 47

• Top chronic conditions were Hypertension, Obesity, Disease Of Thyroid Gland

• 41% male • 39 Employees, 41 Spouses, 24 Dependents • 10 were new enrollees on the plan (2 Newborns)

• 5 are no longer enrolled on the plan • 17 were catastrophic in the base period

(Base: $249K, Norm: $0K) • 87% Gaps in Care compliance rate

• Top individual was $1.9M • 91% of spend was in-network

• 69% have 2+ chronic conditions #N/A

• 14 exceeded the catastrophic threshold based on medication related spend

• Lower Respiratory System was the highest diagnostic category by spend (1 individuals)

• Specialty medications (both medical and pharmacy) made up 13% of the total

Catastrophic individuals accounted for 27% of the total spend, which is below the norm of 29% Total HCC spend was $29.1M

• #2 Internal/External Injury (2 individuals)

Top 10 Claimants #

ICD Major

ICD Minor

SRx Condition

Medical

Pharmacy

1

Musculoskel/Fracture/Sprain/Strain

Fractures/Dislocations

$1,937,930

$0

2

Musculoskel/Fracture/Sprain/Strain

Fractures/Dislocations

$1,388,460

$0

3

Lower Respiratory System

Other Lower Respiratory

$1,360,481

$0

4

Neurological/Cerebrovascular

Cerebrovascular

$1,057,499

$0

5

Musculoskel/Fracture/Sprain/Strain

Back

$864,286

$0

Med Srx $2,177 $939

Pharm Srx

Total

Cat in Base

$0

$1,940,107

N

$0

$1,388,460

N

$0

$1,361,420

N

$0

$1,057,499

N

$0

$864,286

N

6

Heart/Circulatory

Ischemic

$816,511

$0

$112

$0

$816,624

N

7

Blood And Blood Forming Organs

Other Blood Disorder

IVIG/Immune-related

$634,016

$0

$102,481

$0

$736,497

N

8

Neoplasms

Care And Treatment - Neoplasm

Cancer

$162,601

$0

$500,068

$0

$662,668

N

9

Musculoskel/Fracture/Sprain/Strain

Fractures/Dislocations

$650,850

$0

$0

$650,850

N

10

Internal/External Injury

Complications Of Surgical/Med Care

$604,491

$0

$0

$604,491

Y

*No longer enrolled SRx – specialty medications 14

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Specialty Pharmacy Specialty Medication Summary

Medical Specialty Rx Spend

Base Medical SRx (HCP/Home Infusion) Medical SRx (OP/IP Facility) Total Specialty Rx

Current

$31 $9 $40

$27 $12 $39

Trend -11.3% 32.7% -1.6%

18%

Norm $24 $14 $38

70% of Medical Specialty Spend was at a lower-cost home/office setting

Cancer Multiple Sclerosis Ra/Psoriasis/Crohn's Ivig/Immune-Related Neutropenia All Other

4% 47%

8% 11% 12%

Top 10 Specialty Drugs by Spend Rank

Members

Base

Current

Drug Name

Condition

3

1

OCREVUS (Med SRx)

38

2

8

Scripts

Spend

Base

Current

Base

Current

Base

Current

Multiple Sclerosis

6

6

11

13

$413,604

$495,979

TRODELVY (Med SRx)

Cancer

1

1

1

30

$17,582

$393,359

3

DARZALEX FASPRO (Med SRx)

Cancer

2

2

20

30

$236,592

$371,369

-

4

TIVDAK (Med SRx)

Cancer

0

1

0

12

$0

$358,007

4

5

MELPHALAN (Med SRx)

Cancer

1

1

2

2

$376,224

$338,348

9

6

PERJETA (Med SRx)

Cancer

1

3

13

17

$185,683

$291,919

7

7

ORENCIA (Med SRx)

Ra/Psoriasis/Crohn's

12

9

72

71

$250,509

$251,397

13

8

TYSABRI (Med SRx)

Multiple Sclerosis

3

3

22

32

$159,675

$231,447

11

9

GAMUNEX-C (Med SRx)

Ivig/Immune-Related

2

3

22

24

$162,861

$231,403

-

10

ERBITUX (Med SRx)

Cancer

0

1

0

10

$0

$173,524

15

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Cancer Summary Cancer Insights

Cancer Screening Rates (total population)

Cancer % of Total Spend •

•

•

•

•

•

$10.6 M Cancer Spend

Cancer contributed 3.5% to medical plan trend

10%

27 members reached $100k with cancer as the primary diagnosis, 15 in the base period Active prevalence is 3.3% an increase of 0.1% from 3.2% in 2024 46.8% of medical SRX spend was for cancer treatment 67% of members in active treatment also have a Cardiodiabesity condition 8% of Cancer claimants are utilizing their behavioral health benefits

427 individuals had a cancer episode 52% male Average Age: 57.3 Prevalence %: 3.3% 28% have a behavioral diagnosis

Breast

71% 66%

Cervical

57% 58%

Colorectal

43% 47%

Base

Prostate

Skin Intestinal Eye Myeloma

67 61

163 13 1 4

Norm

Top Comorbidities

Top Cancers by Spend Breast

Current

$2,349 K $840 K

Hypertension

39%

Obesity

$812 K

28%

Conditions - Male

26%

$799 K $656 K $651 K

Thyroid

19%

Visual Disturbance

19%

# of Members

Support 100% of cancer members identified for case management were engaged

Top Cancer Drugs by Spend # Members

Spend

Trodelvy - Med SRx

1

$393,359

Darzalex Faspro - Med SRx

2

$371,369

Tivdak - Med SRx

1

$358,007

Melphalan - Med SRx

1

$338,348

Perjeta - Med SRx

3

$291,919 16

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Cardiodiabesity A complex condition of three diagnoses at once: 1 Hypertension/ Hyperlipidemia

2 Type II diabetes

3

2.5 X

32%

4,103 Members with

Cardiodiabesity member spend

one of the above chronic conditions

Obesity

Progressive disease | Costly | Projected to get even worse $24,129 $20,563

50%+ by 2030

$719 Billion

$17,990

Up to 6 times greater

$17,426

$15,447

$14,362 $9,631 $5,526

More than half of U.S. adults are projected to be obese by 2030.*

Combined annual cost of cardiovascular disease, diabetes and obesity.*

Total health care costs for people with comorbid behavioral and physical health conditions.*

None HTN/HPL

2,494

Obesity

2,313

Diabetes

671

# Unique Members

4,103

Supporting Chronic Conditions Diabetes Prevention Digital Care Program to encourage lifestyle change and chronic condition coaching.

Focusing On Whole-person Behavioral Health Counseling, behavioral support and lifestyle change programs.

Driving Affordability Cost caps, including $25 for select insulins, reduce out-of-pocket costs on qualifying drugs.1

1,347

1,382

2 Conditions

130

279

703

All 3

132

130

Spend

1.0X

2.2X

3.2X

3.7X

Rx as % of Total

0%

0%

0%

0%

% taking a GLP-1

0%

0%

0%

0%

Chance of being a HCC

1.0X

2.8X

4.3X

3.4X

Strategies Driving Interactive Well-being Solutions Wellness challenges to improve health with Cigna Healthcaresm well-being solution, with incentive option available.*

8,800

1 Condition

ER Visits

1.0X

1.5X

1.6X

2.3X

IP Admissions

1.0X

1.2X

1.5X

2.7X

Behavioral Visit Prevalence

10%

12%

9%

9%

% with MSK spend above $5K

3%

9%

13%

14%

** This exhibit excludes members without adequate time on the plan. ** Excludes HCCs

17

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Musculoskeletal Prevalence

Diagnostic Categories by Spend

% of Medical Spend

1%

35%

4%

9%

23%

0% Joint Muscle/Connective Tissue

28%

Fractures/Dislocations Back

18%

Sprains/Strains

(M) 50% | (F) 50%

Bone

$155

Avg. Age: 42.3

20%

MSC Distribution of Spend

Outpatient Service Minor Spend Distribution 1%

6%

1%

95

4%

Surgical

11%

16% Professional

Therapy

13%

Diagnostic

Other Inpatient

Steerable ER visits related to MSK in the current period (Base: 99)

Emergency Room

Outpatient

34%

Congenital Musculoskeletal

Musculoskeletal made up 23% of total medical spend, compared to 20% in the base period.

35% of claimants had a Musculoskeletal diagnosis, compared to 34% in the base period.

44%

Aftercare

20%

70%

Rehab Other

Comments •

• •

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Top Professional Surgeries Knee Arthroplasty ($105K ) and Spinal Fusion ($102K) MSK/Pain Mgt savings ($308K) PT OPUM intervention and savings ($23K)

Women’s Health > Preventive care > Healthy behaviors > Physical/emotional changes > Healthy eating > Adequate sleep > Physical activity

Health spend for women evolves throughout each decade.

59%

49%

of the total spend

of the population

> Preventive care > Contraception > Fertility & sexual health > Skin changes > Family history > Mental health > Bone strength

> Mammograms > Mental health > Perimenopause > Menopause > Colonoscopies > Overall health Risk > Mammograms > Bone density screening > Menopause > Mood changes > Memory loss > Pelvic floor support > Ongoing doctor visits > Social & physical activity > Continue screenings, medications, and treatments

Whole Person Care

Demographics & Spend

6,334 Members Employees - 1,039 Spouses - 2,592 Dependents - 2,703 Age Band 0-17 18-29 30-39 40-49 50-59 60+

Dist % 29% 19% 16% 15% 12% 9%

$0,821 PMPM 32.1 Avg Age

Female% 50% 49% 48% 49% 49% 48%

Action: 20s/30s > Preventive care > Contraception > Fertility & sexual health > Skin changes > Family history > Mental health > Bone strength

Well-Visit Rate:

61%

Cancer Screenings: Breast Cervical Colorectal

71% 57% 41%

Behavioral Health:

0%

Pregnancies: Total EE, SP, DEP C-Section %

173 11%, 69%, 20% 27%

Specialized condition-specific support and case management for complex needs Perimenopause & Menopause > Behavioral resources > Hormone therapy > Nutrition counseling > Trained specialists Cancer > Personalized nurse advocates > Behavioral health cancer expertise > Medical specialty drug management > Know Your Lemons® Fertility & Maternity > Clinical, behavioral, and pharmacy support > Progyny (available soon through Cigna) > One Guide

Total Spend PMPM (Excludes HCCs) $1,200 $1,000

Virtual Women’s Health Clinic Visana Health Comprehensive women’s health clinic treating menstruation to menopause in all 50 states

$800 $600 $400 $200 $0

0-17

18-29

30-39

Male

40-49

50-59

60+

Women’s Health Wellness Library

Female

19

Behavioral Health Top Conditions by Prevalence & Spend Reactive Stress Disorder

21%

Anxiety

14%

Alcohol Use Disorders

24% 23% 26%

Depression ADD/ADHD

34%

3%

9%

2%

% Members

17% % Spend

Our behavioral solutions integrate care for the whole person – body and mind.

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

•

Clinical Navigator assigned to individuals with more complex needs.

•

100% follow-up with Care Navigator digitally or by telephone to ensure customer needs are met.

•

Unlimited in-the-moment consultations lasting up to 60 minutes.

Population Health Healthy/At-Risk

Non-Users (Members with no claims, episodes of care, or preventive care)

10%

(Members with preventive care, infections, minor injuries, Maternity, many cancers, joint replacements, trauma, etc.))

Base 10% Norm 17%

of the population

Percent of Non-Users on the plan for 12+ months

Chronic

44%

(Diabetes, hypertension, COPD)

46%

Base 47% Norm 42%

of the population

26% of total spend* Base 29%

70%

Base 43% Norm 41%

of the population

74% of total spend* Base 71% * Spend = Fee for Service only

Non-Users by Relationship

Employee Spouse

Preventive Rates by Age - Total Population 35%

0-17 18-29

14%

30-39

Dependent

Top Chronic Conditions 73%

29% 41%

Hyperlipidemia

27.5 Avg Age

Age Band

% by Age Band

0-17

7%

18-29

18%

30-39

10%

40-49

5%

50-59

3%

60+

3%

40-49

51%

50-59

50%

60+

53%

50% - Well Visit Rate (Annual) (Base 50% Norm 48%) 71% - Breast Cancer Screening (Norm 66%) 57% - Cervical Cancer Screening (Norm 58%) 43% - Colorectal Cancer Screening (Norm 47%)

Diabetes Depression/Anxiety

13%

11% 11%

Hypertension

50%

M: 70%, F: 30%

10%

Obesity

4%

5%

4% 5%

4% 4%

Gaps in Care Compliance - (Total Pop) 79% - Base 78% - Current 77% - Norm

21

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Virtual Care A simplified experience so a member can get the best care both virtually and in person through an integrated ecosystem of providers when and where they need it most

29%

Member Utilization

14%

1% Total

*Adjusted for change in population

Cigna Medical

Cigna MD Live MD Live PCP MD Live PCP MD Live MD Live Behavioral Urgent Care - Wellness - Routine Behavioral Dermatology

Cigna Medical Provider Virtual Visits

by Condition

Cigna Behavioral Virtual Visits

by Condition

End/Nutr/Metab

19%

5%

Anxiety

7%

Gen Med Diag 35%

Neurological

16%

31%

9%

10%

13%

Reactive Stress Disorders Depression

Ear,Nose,Throat

Mental Disorder

Gastrointestinal

ADD/ADHD

All Other

All Other

19%

8%

53

33%

29

3,413

99

Total Behavioral Visits

Current

54

15%

37

19%

5

875

3

Users with Multiple Visits

2

10%

663

13%

630

1,841

Base

3,314

Unique Users

2,512

5,878

23%

1,709

Total Visits

26%

1,432

Trend

Virtual Care Visits by Provider Base vs Current

5,878

Current

Trend Per K* 4,664

Summary

Demographics Demographics * 37% Employees * 37% Employees * 61% Female * 61% Female

29%

Demographics * 26% Employees * 67% Female

22

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Appendix

23

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

Total Plan Spend by Condition Top conditions by plan spend Base

% of Total Spend

32.0%

Current

Norm

24.0%

16.0%

8.0%

0.0%

Musculoskeletal

Neoplasms

Neurological

Gastrointestinal

Circulatory

Gen Med Diag

Int/Ext Injury

Ear,Nose,Throat

Pregnancy

Respiratory

All Other

Top ICD conditions PMPM ICD Category

Base

Claimants per 1k

Trend Current Contribution

Spend per Claimant

Norm

Base

Current

Trend

Base

Current

Trend

Musculoskeletal

$102.99

$154.50

9.8%

$68.22

377.2

370.3

-1.8%

$3,277

$5,007

52.8%

Neoplasms Neurological

$49.81 $47.55

$68.15 $54.49

3.5% 1.3%

$65.99 $32.18

155.4 182.9

152.2 180.0

-2.1% -1.6%

$3,846 $3,120

$5,373 $3,634

39.7% 16.5%

Gastrointestinal

$36.07

$50.20

2.7%

$38.79

167.1

166.8

-0.2%

$2,590

$3,612

39.5%

Circulatory Gen Med Diag

$31.02 $39.80

$48.30 $47.99

3.3% 1.6%

$38.16 $45.50

179.2 707.9

176.2 703.1

-1.7% -0.7%

$2,077 $675

$3,291 $819

58.5% 21.4%

Int/Ext Injury

$27.30

$30.34

0.6%

$18.78

100.0

95.2

-4.8%

$3,277

$3,826

16.7%

Ear,Nose,Throat Pregnancy

$27.65 $17.66

$29.20 $26.28

0.3% 1.6%

$19.95 $26.37

491.0 26.9

460.3 27.4

-6.2% 1.6%

$676 $7,870

$761 $11,527

12.7% 46.5%

Respiratory All Other

$15.94 $130.63

$23.28 $147.24

1.4% 3.2%

$15.56 $147.13

177.2 1392.8

161.3 1338.4

-9.0% -3.9%

$1,080 $1,125

$1,732 $1,320

60.4% 17.3%

Total

$526.40

$679.99

29.2%

$516.64

980.8

949.7

-3.2%

$6,440

$8,592

33.4%

Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2026 Cigna Healthcare.

24

Medical Service Category Trend Detail Trend contribution

Account summary (PMPM basis)

16.0% 12.0% 8.0%

Base

Current

Trend

Trend Contribution

Norm

Non-Catastrophic Plan Inpatient Outpatient

$38 $151

$52 $214

38.7% 41.9%

2.8% 11.9%

$44 $149

Professional Other Total Non-Cat Plan

$155 $52 $395

$161 $57 $484

3.8% 9.7% 22.4%

1.1% 0.9% 16.7%

$128 $37 $358

$5 $131 $532 $33 $499

$6 $196 $686 $34 $652

10.0% 49.4% 29.0% 2.9% 30.7%

0.1% 12.2% 29.0% 0.2% 28.8%

$28 $159 $545 $71 $474

Capitation Catastrophic Plan Total Plan Spend - Medical Cost Share - Medical Net Employer Paid - Medical

4.0% 0.0% -4.0% IP 2.8%

OP 11.9%

Non-Cat Inpatient Spend

Prof 1.1%

Oth 0.9%

+$2.4M

• Maternity was the top non-catastrophic admission category representing 48% of admissions and 33% of spend.

• Total admits/K rose by4% and bed days/K rose by 3%.

• Cost per admit rose from $10,177 to $13,525 or up 33%.

• 175 completed pregnancies in the current period.

Cat 12.2%

Cap 0.1%

Non-Cat Outpatient Spend

+$10.3M

• Key Drivers: Emergency Room +$3.8M. Surgery +3.3M, and Diagnostic +$3.1M ➢ Emergency Room – Visits/k up 6.6%, cost per visit up 35%. ➢ Surgical – Visits/k up 2%, cost per visit up 42% ➢ Diagnostic – Visits/k down -6%, cost per visit up 55%.

Non-Cat Professional Spend

• Key Drivers: Evaluation & Mgmt. +$705K, Pathology +$269K, Orthopedic+$189K. • 756 (+14%) MD Live Provider virtual visits • 1,709 (+19%) Cigna Provider virtual visits.

• 3,413 (+33%) Behavioral Health Provider virtual visits.

Non-Cat Other Spend • Preferred Lab (Lab Corp/Quest Diagnostic) usage fell from 35% to 34% versus norm of 53%.

+$1.6M

+$1M

• Key Drivers: Drugs Administered +$640K, and OMS Services and Supplies +$241K.

• Shifting 25% to preferred providers will generate $504K. 25

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