PART I ITEM 1 Business insured and self-insured medical, dental, behavioral health, vision, and prescription drug benefit plans, health advocacy programs and other products and services that may be integrated to provide comprehensive global health care benefit programs to employers and their employees, including globally mobile individuals. Cigna, either directly or through its partners, offers some or all of these products and services in all 50 states, the District of Columbia, the U.S. Virgin Islands, Canada, Europe, the Middle East, and Asia. Cigna services its globally mobile customers virtually everywhere in the world. These products and services are offered through a variety of funding arrangements such as administrative services only (ASO), guaranteed cost and retrospectively experience rated. Financial information, including premiums and fees, is presented in the Global Health Care section of the MD&A beginning on page 41 and in Note 23 to Cigna’s Consolidated Financial Statements beginning on page 119 of this Form 10-K. Global Health Care seeks to differentiate itself by providing superior customer insights, care delivery, product integration and unique product offerings. Global Health Care expects to accomplish these goals by deepening its reach in selected geographies and market segments as well as accelerating its engagement with preferred health care professionals. For its globally mobile customers, Global Health Care’s strategic advantages include unique health care solutions, seamless worldwide care delivery and superior customer service. With the exception of Health Maintenance Organization (‘‘HMO’’), Medicare, Medicaid and stop loss products, each of Global Health Care’s group health benefit products are offered with alternative funding options (i.e.: administrative services only (‘‘ASO’’ or ‘‘self-insured’’), insured experience rated, and insured guaranteed cost). These funding options are further described on page 5 of this Form 10-K. Approximately 86% of the Company’s commercial medical customers are enrolled in self-insured and experience-rated plans, where lower costs of providing health care directly benefit our corporate clients and their employees, with the remainder being insured under guaranteed cost plans. CIGNA CORPORATION -  2012 Form  10-K 3 Cigna’s principal health care products (discussed below) include: Commercial Medical – U.S. and International Health Plans Principal Products and Services Health Plans  – group and individual medical coverage: GLYPH<127> Commercial Medical: U.S. and International –  medical plans covering domestic-based employees and, for certain multinational employers, their globally mobile employees. In order to engage customers in their health care choices, consumer- driven core medical plans are often combined with the Cigna Choice Fund suite of accounts. GLYPH<127> Government  – Medicare Advantage, Medicare Part D and Medicaid plans sold to Medicare or Medicaid-eligible individuals (primarily seniors). GLYPH<127> Specialty Products –  products and services that improve quality, lower the cost of medical services and help customers achieve better health outcomes. These products can be sold on a standalone basis but are most effective when integrated with a Cigna-administered health plan. GLYPH<127> Stop Loss Coverage.  Global Health Care offers stop loss insurance coverage for self-insured plans. This stop loss coverage reimburses the plan for claims in excess of a predetermined amount, for individuals (‘‘specific’’), the entire group (‘‘aggregate’’), or both. Global Health Care also includes stop loss features in its experience- rated policies (discussed below). GLYPH<127> An FSA allows customers to pay for IRS-approved health care expenses with pre-tax employee contributions. Unused funds in an FSA do not accumulate from year to year, but are forfeited by the employee. 3. HSA plans combine a high deductible health plan with a tax-advantaged savings account funded by customer contributions that offers mutual fund investment options. Funds in an HSA can be used to pay the deductible and other IRS-approved health care expenses. The health savings account is portable and unused funds accumulate from year to year. 2. Cigna’s Choice Fund HRA is funded by employer contributions and is often combined with a high deductible plan. HRA dollars can be rolled over from year-to-year at the plan sponsors’ discretion. 1. Choice Fund GLYPH<H23041>  suite of Consumer-Driven Products.  In connection with many of the health care products described above, Global Health Care offers the Cigna Choice Fund suite of consumer-driven products, including  Health Reimbursement Accounts  (‘‘HRA’’), Health Savings Accounts  (‘‘HSA’’) and  Flexible Spending Accounts (‘‘FSA’’). These plans can be used to pay medical care expenses not covered by a base medical plan and are designed to encourage customers to understand and manage their health and health benefits. GLYPH<127> Preferred Provider Plans.  Global Health Care also offers an open access product line that features a network with even broader access than the Managed Care Plans with no option to designate a primary care physician, in-network and out-of-network coverage, and may be at a somewhat higher medical cost. GLYPH<127> The  Government  operating segment offers Medicare Advantage plans to seniors in 13 states and the District of Columbia, Medicare Part D plans in all 50 states and the District of Columbia and Medicaid plans. GLYPH<127> Managed Care Plans.  Global Health Care offers a broad product line of managed care benefit plans that use meaningful coinsurance and copayment differences to encourage the use of ‘‘in-network’’ versus ‘‘out-of-network’’ health care providers and the use of primary care physicians. While these products offer access to a broad national network of ‘‘in-network’’ health care providers (that is somewhat smaller than the network used with the preferred provider (‘‘PPO’’) plan product line), employers may elect to utilize a subset of Cigna’s network to better manage costs and quality. GLYPH<127>