Cigna 2009 Annual Report Download - page 39

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With respect to the expatriate benefits business, CIGNA International is a market leader in the U.S. Its primary competitors
include U.S.-based and European health insurance companies with global expatriate benefits operations. For the health care
operations in the United Kingdom and Spain, the primary competitors are regional and local insurers, with CIGNA's market share at
less than 5% of the premiums of the total local health care market.
CIGNA International expects that the competitive environment will intensify as U.S. and Europe-based insurance and financial
services providers pursue global expansion opportunities.
Industry Developments
Pressure on social health care systems and increased wealth and education in emerging markets is leading to higher demand for
products providing health insurance and financial security. In the life, accident and supplemental health business, direct marketing is
growing and attracting new competitors while industry consolidation among financial institutions and other affinity partners continues.
Increased regulations requiring foreign workers to show proof of health insurance are creating opportunities for CIGNA
International’s health care businesses. See “Risk Factors” beginning on page 35 of this Form 10-K for a discussion of risks related to
CIGNA International.