With a significant position in the US health insurance market, CIGNA covers some 14.5 million Americans with its various medical plans. The firm's offerings include PPO, HMO, point-of-service (POS), indemnity, and consumer-directed products, as well as specialty coverage in the form of dental, vision, pharmacy, and behavioral health plans. It also sells group accident, life, and disability insurance. Customers include employers, government entities, unions, Medicare recipients, and other groups and individuals in North America. Internationally, CIGNA sells life, accident, and health insurance in parts of Europe and Asia, and provides health coverage to expatriate employees of multinational companies. In 2017 a federal judge blocked Cigna's merger with rival Anthem.