2019 Political Contributions and Lobbying Activity Report 930861 03/20 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 2 Table of Contents Opening Letter from David Cordani, President and CEO 3 Overview and Governance 4 Political Contributions 5 Corporate Contributions 6 Lobbying Activity and Priorities 11 Trade Association Memberships 12 CignaPAC Annual Report About CignaPAC 13 Board Oversight 13 CignaPAC Contribution Strategy 14 Cigna PAC Contributions 15 Cigna Missouri PAC Contributions 34 Cigna New York PAC Contributions 36 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 3 The past year was a defining one for Cigna as an organization, and for the entire health care industry. We are at an inflection point in health care in the United States and the stakes couldn’t be higher. Health spending continues to increase, while Americans continue to get sicker. All of this constricts economic growth, which forces employers to choose between providing benefits or creating jobs. Ultimately American families pay the price. It is indisputable that a transformative change in health care is needed to further evolve the U.S. system and meet the needs of today’s consumers. In 2019, we brought together the best capabilities of Cigna, Express Scripts and eviCore to build a more sustainable model of health service delivery. As a result, we are becoming an even greater force for driving positive change, and furthering our vision of greater affordability, quality and predictability for our customers, patients and communities. David M. Cordani President and As the political debate around health care intensifies, we remain Chief Executive Officer committed to addressing today’s dynamic health care environment through active, principle-based, nonpartisan engagement with policy makers in Washington, DC, as well as at the state and local levels. Whether it is critically important topics such as broadening approaches to drug pricing and transparency; addressing the underlying drivers of health care costs; or expanding the bright spots within our current system – largely within the employer-based system and Medicare Advantage – there has never been a more important time for Cigna to be a powerful and reliable voice in the dialogue. In Cigna’s 2019 Political Contribution and Lobbying Activity Report, you’ll find details about our political contributions, advocacy efforts and the annual report of the Cigna Political Action Committee (CignaPAC). This report details how we translate our mission into constructive engagement and advocacy with elected officials. In 2020, Cigna will remain a strong advocate in the public policy arena for a health care system that is affordable and sustainable for our approximately 170 million valued customer relationships. As the leading global health service company, we remain committed to improving the health, well-being and peace of mind of those we serve. < Table of Contents 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 4 Overview and Governance Cigna takes its engagement in the legislative, regulatory and public policy areas very seriously, approaching all our efforts with care and integrity. There are two major components of Cigna’s political activity: (1) political contributions and (2) lobbying efforts. This report is organized to provide information on both of these activities. As Cigna engages in political activity, it adheres to strict governance standards designed to ensure alignment with Cigna’s mission and strategic goals. All political contributions that are made directly by the Company must be made in accordance with Political Activity and Government Contacts policy, which requires, among other things, oversight of decisions at the highest corporate level. Political contributions that are made through CignaPAC are reviewed and approved by the CignaPAC board, comprised of executive-level Cigna leadership and other business leaders, in accordance with the CignaPAC Contribution Guidelines. With respect to the Company’s lobbying activities, the Vice President of Global Public Policy and Federal Government Affairs and the Vice President of State Government Affairs report directly to the General Counsel and review lobbying efforts with Cigna’s enterprise leadership, including the Chief Executive Officer, on a regular basis. Additionally, all memberships in trade associations are reviewed by the General Counsel and the Chief Executive Officer. The Company also maintains an Enterprise Risk Management function. This company-wide initiative involves the Board (and its committees), Cigna’s management, Cigna’s Chief Risk Officer and General Auditor, and Cigna’s internal audit function. Together, they work in an integrated effort to (1) identify, assess, prioritize and monitor (as each of their roles dictates) a broad range of risks (e.g., financial, operational, business, compliance, reputational, governance and managerial), and (2) formulate and execute plans to monitor and, to the extent possible, mitigate the effect of those risks. Within this enterprise risk framework, the Corporate Governance Committee of Cigna’s Board of Directors has oversight of and evaluates any material financial, legal, reputational or other risks associated with Cigna’s corporate political spending and lobbying activities. In addition, the Corporate Governance Committee biannually reviews compliance with Cigna’s Political Activity and Government Contacts policy, including the contributions made under that policy by the Company during the previous year, and annually reviews lobbying expenses and trade association memberships. < Table of Contents 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 5 Political Contributions Cigna regularly supports federal, state and local officials, candidates, parties and other politically oriented groups and organizations that the Company believes can advance its mission, business objectives and goals, including principles or issues that support Cigna’s vision for a sustainable health care system. As Cigna considers making political contributions, it is always guided by the Company’s strategy and mission, demonstrating an eagerness to work with officials of various political and philosophical beliefs and without regard for the private political preferences of its executives. Cigna makes political contributions in two ways: (1) corporate contributions and (2) through CignaPAC. Cigna has strict standards in place governing its political giving activity, and all its contributions are made in accordance with applicable state and federal laws. In addition, the Company keeps the work of the CignaPAC separate from other Company giving. Accordingly, this section of the report provides information specific to Cigna’s direct corporate contributions, and the CignaPAC Annual Report at the end of the report provides information regarding contributions made through CignaPAC. < Table of Contents 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 6 Corporate Contributions The Cigna Political Activity and Government Contacts policy authorizes the use of corporate funds in certain states where corporations are permitted to contribute to state election campaigns. Cigna made the following corporate contributions to state level candidates. Title First Name Last Name State Party Amount Atty. Gen. Leslie Rutledge AR R $5,000 Sen. Toni Atkins CA D $6,400 Assm. Frank Bigelow CA R $1,000 Sen. Steven Bradford CA D $2,000 Assm. Autumn Burke CA D $1,000 Sen. Anna Caballero CA D $1,000 Assm. Ian Calderon CA D $4,000 Assm. Wendy Carrillo CA D $1,000 Assm. Jim Cooper CA D $2,000 Assm. Tom Daly CA D $2,000 Sen. Lena Gonzalez CA D $1,000 Sen. Bob Hertzberg CA D $2,000 Assm. Sydney Kamlager-Dove CA D $1,000 Sen. Connie Leyva CA D $1,000 Assm. Monique Limon CA D $1,000 Assm. Chad Mayes CA R $1,000 Sen. Holly Mitchell CA D $1,000 Sen. Richard Pan CA D $2,000 Sen. Anthony Portantino CA D $2,000 Assm. Anthony Rendon CA D $5,000 Sen. Susan Rubio CA D $4,000 Assm. Miguel Santiago CA D $2,000 Assm. Jim Wood CA D $4,000 Rep. Jehan Gordon-Booth IL D $1,000 Sen. Edward Berger KS R $200 Sen. Richard Billinger KS R $200 Sen. Barbara Bollier KS R $200 Rep. Tom Cox KS R $200 Sen. Jim Denning KS R $200 Rep. John Eplee KS R $200 Rep. Blaine Finch KS R $200 Sen. Bruce Givens KS R $200 Rep. Daniel Hawkins KS R $200 < Table of Contents 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 7 Title First Name Last Name State Party Amount Rep. Jim Kelly KS R $200 Rep. Brenda Landwehr KS R $200 Sen. Jeff Longbine KS R $200 Sen. Ty Masterson KS R $200 Rep. Monica Murnan KS D $200 Rep. Cindy Neighbor KS D $200 Sen. Robert Olson KS R $200 Rep. Ron Ryckman KS R $200 Rep. Tom Sawyer KS D $200 Sen. Gene Suellentrop KS R $200 Rep. Jene Vickrey KS R $200 Sen. Mary Ware KS D $200 Rep. Lawrence Bagley LA R $1,000 Sen. Gerald Boudreaux LA D $750 Sen. Troy Carter LA D $750 Sen. Heather Cloud LA R $750 Rep. Paula Davis LA R $500 Rep. Michael Echols LA R $500 Rep. Randal Gaines LA D $500 Sen. Ryan Gatti LA R $750 Rep. Lance Harris LA R $500 Sen. Ronnie Johns LA R $750 Rep. Edmond Jordan LA D $500 Sen. Eddie Lambert LA R $750 Atty. Gen. Jeffrey Landry LA R $5,000 Sen. Gary Smith LA D $750 Sen. Kirk Talbot LA R $1,000 Sen. Rick Ward LA R $750 Sen. Mack White LA R $500 Rep. Ben Frederick MI NP $750 Sen. Curtis Hertel MI NP $250 Sen. Mike Shirkey MI NP $1,500 Sen. Nicole Cannizzaro NV D $500 Assm. Lesley Cohen NV D $500 Assm. Jason Frierson NV D $500 Sen. Julia Ratti NV D $500 Sen. James Settelmeyer NV R $500 Assm. Robin Titus NV R $500 Sen. Sean Bennett SC R $500 NP – No party affiliation. < Table of Contents 2019 POLITICAL CONTRIBUTIONS AND LOBBYING ACTIVITY REPORT 8 Title First Name Last Name State Party Amount Sen. Ronnie Cromer SC R $500 Rep. Craig Gagnon SC R $250 Sen.