PART I ITEM 1 Business Cigna’s principal competitors in its U.S.-based business are: health. This is accomplished primarily through financial incentives, access to enhanced medical quality data and other information sharing. The effective use of the Company’s health advocacy, customer insight and physician engagement capabilities, along with decision support tools (some of which are web-based) and enabling technology are critical to success in the health care industry, and Cigna believes its capabilities in these areas will be competitive differentiators. The primary competitors of the international health care business include U.S.-based and European health insurance companies with global health benefits operations. For the Company’s international health care operations in the United Kingdom and Spain, the primary competitors are regional and local insurers. Competition also arises from smaller regional or specialty companies with strength in a particular geographic area or product line, administrative service firms and, indirectly, self-insurers. In addition to these traditional competitors, a new group of competitors is emerging. These new competitors are focused on delivering employee benefits and services through Internet-enabled technology that allows consumers to take a more active role in the management of their On February 15, 2013, CMS issued its Advance Notice of Methodological Changes for Calendar Year (CY) 2014 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies (the ‘‘Notice’’). CMS is accepting comments on the Notice, and final terms are expected to be published on April 1, 2013. While management believes that a significant number of comments from interested parties (including Cigna) will be provided to CMS, there can be no assurance that CMS will amend its current position. Given the uncertainty regarding the final terms of the Notice, the Company cannot estimate the impact that it will have on its business, revenues or results of operations but recognizes that any impacts could be materially adverse. Accordingly, the Company is currently evaluating the potential implications of the Notice, including adjustments that the Company may make to the programs and services it offers to offset any adverse impacts. Cigna’s Group Disability and Life segment provides the following insurance products and their related services: group long-term and short-term disability insurance, group life insurance and accident and specialty insurance. These products and services are provided by subsidiaries of Cigna Corporation. Cigna markets products in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Canada. return to work rate. Examples of the benefits of this integrated approach (for which Cigna may receive fees) include: Long-term and short-term disability insurance products and services generally provide a fixed level of income to replace a portion of wages lost because of disability. Cigna also provides assistance to employees in returning to work and assistance to their employers in managing the cost of employee disability. Group disability coverage is typically employer-paid or a combination of employer and employee-paid, but may also include coverage paid for entirely by employees. As measured by 2012 premiums and fees, disability constituted approximately 45% of this segment’s business. Approximately 12,300 insured disability policies covering approximately 6.5 million lives were outstanding as of December 31, 2012. Cigna is an industry leader in returning employees to work quickly, resulting in higher productivity and lower cost for employers and a better quality of life for their employees. Cigna’s disability insurance products may be integrated with other disability benefit programs, behavioral programs, medical programs, social security advocacy, and leave of absence administration. Cigna believes this integration provides customers with increased efficiency and effectiveness in disability claims management, enhances productivity and reduces overall costs to employers. Coordinating the administration of the segment’s disability programs with medical programs offered by Cigna HealthCare provides enhanced opportunities to influence outcomes, reduce the cost of both medical and disability events and improve the Life insurance products offered by Group Disability and Life include group term life and group universal life. Group term life insurance may be employer-paid basic life insurance, employee-paid supplemental life insurance or a combination thereof. Group universal life insurance is a voluntary life insurance product in which the owner may accumulate cash value. The cash value earns interest at rates declared from time to time, subject to a minimum guaranteed contracted rate, and may be borrowed, withdrawn, or, within certain limits, used to fund future life insurance coverage. As measured by 2012 premiums and fees, group life insurance constituted approximately 46% of this segment’s business. Approximately  6,200  group  life  insurance  policies  covering approximately 5.6 million lives were outstanding as of December 31, 2012. CIGNA CORPORATION -  2012 Form  10-K 9 other large insurance companies that provide group health and life insurance products; GLYPH<127> Blue Cross and Blue Shield organizations; GLYPH<127> stand-alone HMOs and PPOs; GLYPH<127> HMOs affiliated with major insurance companies and hospitals; and GLYPH<127> national managed pharmacy, behavioral health and utilization review services companies. GLYPH<127> using information from the health care and disability databases to help identify, treat and manage disabilities before they become chronic, longer in duration and more costly; and GLYPH<127> proactive outreach from Cigna Behavioral Health to assist employees suffering from a mental health condition, either as a primary condition or as a result of another condition. GLYPH<127> Life Insurance Disability Principal Products and Services Group Disability and Life C.