The short answer
Cigna is one national company, part of The Cigna Group, and its small group page lists plans only for Arizona; most of its employer customers are in self-funded plans. Blue Cross Blue Shield is about 33 independent local companies, and your local Blue generally sells small group plans across its territory. Only a licensed broker's quote shows what each offers your group.
On this page
Cigna and Blue Cross Blue Shield are built very differently: one is a single national company, the other is a brand shared by dozens of local companies. They also sell to different ranges of group size. Here is how they compare on published company facts.
The quick picture
| Cigna | Blue Cross Blue Shield | |
|---|---|---|
| What it is | One company, part of The Cigna Group | About 33 independent local companies sharing a brand |
| National commercial share (AMA, 2024 data) | About 9%, fourth largest | About 43% for all Blues combined |
| Small group market, 2 to 50 employees | Arizona only (Cigna’s small group page) | Generally sold across each Blue’s territory |
| Funding types | Fully insured, level-funded and self-funded | Fully insured, level-funded and self-funded, varying by Blue |
| Out-of-state employees | Cigna’s national network | BlueCard, using other Blues’ networks |
| Pharmacy business | Express Scripts (Evernorth, part of The Cigna Group) | Chosen by each Blue |
Group sizes each one sells to
Cigna has almost stepped out of selling fully insured plans to small businesses. Its small group page lists plans only for Arizona for 2026 and 2027, and it stopped new small group sales in Georgia and Tennessee from November 1, 2025. Cigna describes its employer business as mainly mid-size and large groups.
The Blue companies, by contrast, mostly still sell small group plans in their territories, and several, such as Florida Blue, also sell level-funded plans.
Self-funding at Cigna
Most of Cigna’s employer business is self-funded. About 79% of its medical customers were in self-funded plans at the end of 2025. Blue companies also sell level-funded and self-funded plans, each under its own names. Our self-funded health insurance page explains how self-funding works in general.
Networks
Cigna runs a national network. Its 2025 annual report cites about 1.7 million physicians and more than 6,000 hospitals.
A Blue’s network is local first. The Association says Blue companies contract with 97% of physicians and 83% of hospitals nationally, and a Blue is often the largest insurer in its home market. Employees living in another state use that state’s Blue network through BlueCard.
The two carriers count differently, one as a head count and one as a share, so the figures do not compare directly.
International business
Cigna also has a long-standing international health business serving employers with staff overseas.
Ratings
In J.D. Power’s 2026 commercial member study, Blue companies were ranked highest in 11 of 22 regions. Cigna tied for highest in Florida, with Florida Blue, and J.D. Power’s separate 2026 digital experience study placed Cigna first among commercial plans.
AM Best affirmed Cigna’s main insurers at A (Excellent) in March 2026. Ratings differ between Blues, since each is a separate company.
Large employers with staff in many states
Following a settlement of the Blue antitrust case, qualifying large self-funded national employers can, since September 2024, ask for a bid from a second Blue company as well as their home Blue.
Questions to ask a broker about these two carriers
- Which Blue company covers our area, and will Cigna quote a group our size in our state?
- Which funding types will each carrier offer a group our size in our state?
- Which of my employees’ doctors and nearest hospitals are in each carrier’s network?
- How would employees who live in other states or abroad use each carrier’s network?
- How have each carrier’s renewals run for similar groups here?
Our group health insurance quotes form connects you with a licensed broker who can answer these for your business.
How we write these: every comparison uses the carriers' own published information, their parent companies' filings and independent surveys, each listed below with its date. We are not paid by, affiliated with or endorsed by any carrier, and we do not rank them, describe their plan benefits or recommend any plan. Carrier and product names are trademarks of their owners. Plans, networks and prices vary by state, county and group size: only a licensed broker or the insurer can say what is available to your business and explain its terms.
Where our information comes from
- The Cigna Group, Form 10-K for 2025 (filed February 2026)
- Cigna Healthcare, Funding solutions (read October 31, 2026)
- Cigna Healthcare, Small group health insurance plans (read October 31, 2026)
- AM Best, ratings affirmed for The Cigna Group subsidiaries (March 4, 2026)
- Blue Cross Blue Shield Association, Blue Fact Sheet (December 2025)
- Blue Cross Blue Shield Association, Subscriber settlement overview (April 30, 2026)
- J.D. Power, 2026 U.S. Commercial Member Health Plan Study (May 27, 2026)
- American Medical Association, Competition in Health Insurance (December 16, 2025)
- J.D. Power, 2026 U.S. Healthcare Digital Experience Study (April 7, 2026)
- Florida Blue, Level funded plans for employers (read October 31, 2026)