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2008 Financial Results for Health Insurance Companies in Maine
(Detailed version)

The following tables show Maine data for leading health insurers and health maintenance organizations (HMOs) that provide medical expense insurance in Maine. This does not include stop loss, Medicare supplement insurance or other types of health insurance such as disability income insurance, long-term care insurance, or hospital indemnity insurance, which provides a daily hospital benefit unrelated to actual expenses. For each of Maine’s largest companies (those companies who have at least $2 million of medical premium in Maine), the information below is shown. The “All Other Companies” category provides aggregate data for companies with less than $2 million of premium except for enrollment and per member per month data. Data is shown separately for each of three market segments: large group (employers with more than 50 employees), small group (employers with 50 or fewer employees), and individual (people who are not covered by an employer plan and buy coverage directly). Grand totals are shown for each market segment. These grand totals include only the companies included in the tables.

The data shown are as reported by the companies. While the Bureau does check for consistency with other reported data, we cannot vouch for the accuracy of the data.

Here is a list of the items contained in the tables below along with a description of the items:

(1) Number of Covered Lives, Dec. 31: This is the number of people (including dependents) who were covered as of the end of the year

(2) Member Months during Year: This the sum of the number of people covered during each month during the year. One person covered for the whole year represents 12 member months.

(3) Number of Contracts issued in 2008: This is the number of individual or group policies issued during the year and still in force at the end of the year.

(4) Number of contracts issued in 2008 covering policyholders who were uninsured for the prior 90 days: This is the number of individual policies issued to previously uninsured individuals and the number issued to small groups that did not have a previous health plan in the prior 90 days. Some carriers were unable to report this data.

(5) Premiums Earned: This is the amount paid for coverage during the year regardless of when it was paid. For example, premiums paid in December 2007 for coverage in January 2008 are included in 2008 premiums earned but premiums paid in December 2008 for coverage in January 2009 are not included.

(6) Claims Incurred: This is the amount paid for medical services provided during the year regardless of when it was paid. For example, claims paid in January 2008 for services provided in December 2007 are included in 2007 claims incurred but claims paid in January 2009 for services provided in December 2008 are included in 2008 claims incurred. Claims incurred are also shown as a percentage of premium. This is commonly called the “loss ratio” and is sometimes considered a measure of how good a value is received for the premium paid. However, it can be misleading. For example, an insurer that has healthier policyholders, on average, than another insurer may have a lower loss ratio even though it may charge less for similar coverage. Also, if the volume of business is small, experience is subject to random fluctuations.

(7) Increase in Policy Reserves: Policy reserves are held when future premiums are not expected to be sufficient to cover future claims. For example, some types of insurance policies have premiums based on the age when the policy was issued. Even though claims are expected to increase as the person ages, the premiums will not reflect this, so part of the premium in the early years is held in a reserve to cover later claims. This is generally not the case for medical expense insurance and therefore policy reserves are generally not a significant item.

(8) Administrative Expenses: This includes all expenses reported on the companies’ annual financial statement other than claims. Administrative expenses include office space, salaries, utilities, postage, office supplies, commissions, marketing, advertising, cost containment expenses, lobbying expenses, taxes (other than federal income tax), and other expenses. Cost containment expenses are expenses that reduce the amount of health care services provided, including utilization review, fraud prevention and detection, provider contracting, provider network development, smoking cessation programs, disease management programs, and case management.

(9) Underwriting Gain or (Loss): This is the amount of premium left over (or the shortfall) after claims and administrative expenses are paid and any needed increase is added to policy reserves. Underwriting gain differs somewhat from “profit” in that it does not reflect certain items, primarily income from investments, capital gains and losses, and federal income taxes.

(10) Premium per Member Month: This is the average monthly premium per person. It should be noted that policies vary widely with respect to features such as deductibles, copayments, policy limits, and restricted provider networks. Therefore comparing the average premium for different companies or different market segments may be comparing “apples and oranges.” Also shown is the percentage increase (or decrease) from the prior year’s average premium. Here again, the comparison may reflect differing benefit levels. As rates increase, some employers and individuals increase their deductible or make other modifications to their policies in order to reduce the amount of the increase.

(11) Claims per Member Month: This is the average amount of monthly claims per person. Also shown is the percentage increase (or decrease) from the prior year’s average claims. The notes above concerning premium per member month apply equally here. The actual trend in health care costs may be more than the trend in claims because the claims trend may reflect a reduction in benefit levels such as an increased deductible.

The Annual Report Supplements (945 Reports) for Maine’s larger insurers is available on the Bureau of Insurance website. Here is the link: http://www.maine.gov/pfr/insurance/consumer/rule945reports.htm.

Large Group
Aetna (Aetna Health Inc + Aetna Life Ins Co)
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	33,666		32,620		29,673
(2) Member Months During Year	400,315		385,227		329,040
(3) Number of Contracts issued during year	20		116		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$154,913,707	100%	$136,329,980	100%	$107,313,340	100%
(6) Claims Incurred	$120,162,405	78%	$108,453,706	80%	$82,742,581	77%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$21,515,816	14%	$16,042,874	12%	$16,771,266	16%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$13,235,486	9%	$11,833,400	9%	$7,799,493	7%
(10a) Premium per Member Month [(5)/(2)]	$387		$354		$326
(10b) Premium Trend [(10a)/(10a prior year)-1]	9%		9%		11%
(11a) Claims per Member Month [(6)/(2)]	$300		$282		$251
(11b) Claims Trend [(11a)/(11a prior year)-1]	6%		12%		16%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
Anthem Health Plans of ME Inc
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	138,456		143,480		144,807
(2) Member Months During Year	1,676,611		1,708,922		1,734,117
(3) Number of Contracts issued during year	0		0		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$635,899,126	100%	$615,333,056	100%	$611,202,925	100%
(6) Claims Incurred	$561,612,832	88%	$532,649,829	87%	$548,652,721	90%
(7) Increase in Policy Reserves	($15,698)	0%	$0	0%	$0	0%
(8) Administrative Expenses	$40,852,804	6%	$25,015,875	4%	$43,688,644	7%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$33,449,188	5%	$57,667,352	9%	$18,861,560	3%
(10a) Premium per Member Month [(5)/(2)]	$379		$360		$352
(10b) Premium Trend [(10a)/(10a prior year)-1]	5%		2%		14%
(11a) Claims per Member Month [(6)/(2)]	$335		$312		$316
(11b) Claims Trend [(11a)/(11a prior year)-1]	7%		15%		7%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co)
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	27,750		29,707		33,371
(2) Member Months During Year	339,871		378,501		416,085
(3) Number of Contracts issued during year	399		201		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$142,942,246	100%	$126,169,087	100%	$140,673,799	100%
(6) Claims Incurred	$106,420,444	74%	$106,219,635	84%	$125,325,945	89%
(7) Increase in Policy Reserves	0	0%	($815,000)	-1%	$0	0%
(8) Administrative Expenses	$10,380,226	7%	$11,516,714	9%	$18,885,943	13%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$26,141,576	18%	$9,247,739	7%	($4,353,088)	-3%
(10a) Premium per Member Month [(5)/(2)]	$421		$333		$338
(10b) Premium Trend [(10a)/(10a prior year)-1]	26%		-1%		1%
(11a) Claims per Member Month [(6)/(2)]	$313		$281		$301
(11b) Claims Trend [(11a)/(11a prior year)-1]	11%		-7%		11%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
Harvard Pilgrim (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	15,575		13,618		8,906
(2) Member Months During Year	178,546		158,043		96,133
(3) Number of Contracts issued during year	50		54		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$46,007,999	100%	$50,241,490	100%	$28,295,841	100%
(6) Claims Incurred	$53,107,244	115%	$43,830,206	87%	$26,053,411	92%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$8,518,459	19%	$7,818,739	16%	$4,953,068	18%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($15,617,704)	-34%	($1,407,455)	-3%	($2,710,638)	-10%
(10a) Premium per Member Month [(5)/(2)]	$258		$318		$294
(10b) Premium Trend [(10a)/(10a prior year)-1]	-19%		8%		-5%
(11a) Claims per Member Month [(6)/(2)]	$297		$277		$271
(11b) Claims Trend [(11a)/(11a prior year)-1]	7%		2%		-15%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
Mega Life & Health Ins Co
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	0		0		31
(2) Member Months During Year	0		0		314
(3) Number of Contracts issued during year	0		0		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$0	0%	$0	0%	$45,914	100%
(6) Claims Incurred	$0	0%	$0	0%	$23,733	52%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$0	0%	$0	0%	$9,744	21%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$0	0%	$0	0%	$12,437	27%
(10a) Premium per Member Month [(5)/(2)]	$0		$0		$146
(10b) Premium Trend [(10a)/(10a prior year)-1]	0%		0%		298%
(11a) Claims per Member Month [(6)/(2)]	$0		$0		$76
(11b) Claims Trend [(11a)/(11a prior year)-1]	0%		0%		-49%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
United Healthcare Ins Co
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	1,754		1,812		889
(2) Member Months During Year	20,848		20,016		8,796
(3) Number of Contracts issued during year	46		46		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$9,428,899	100%	$6,879,162	100%	$3,221,453	100%
(6) Claims Incurred	$7,636,442	81%	$5,572,002	81%	$2,608,491	81%
(7) Increase in Policy Reserves	$114,113	1%	$82,670	1%	$39,543	1%
(8) Administrative Expenses	$1,500,903	16%	$1,096,582	16%	$516,306	16%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$177,441	2%	$127,908	2%	$57,113	2%
(10a) Premium per Member Month [(5)/(2)]	$452		$344		$366
(10b) Premium Trend [(10a)/(10a prior year)-1]	31%		-6%		22%
(11a) Claims per Member Month [(6)/(2)]	$366		$278		$297
(11b) Claims Trend [(11a)/(11a prior year)-1]	32%		-6%		22%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
All Other Companies
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31
(2) Member Months During Year
(3) Number of Contracts issued during year
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days
(5) Premiums Earned	$3,858,380	100%	$5,815,240	100%	$7,132,858	100%
(6) Claims Incurred	$3,690,585	96%	$4,677,554	80%	$4,569,567	64%
(7) Increase in Policy Reserves	($147,299)	-4%	($253,205)	-4%	$325,242	5%
(8) Administrative Expenses	$474,199	12%	$1,397,602	24%	$710,575	10%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($159,105)	-4%	($6,711)	0%	$1,527,474	21%
(10a) Premium per Member Month [(5)/(2)]
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Large Group Totals for companies who are not displayed in the tables above. In addition, this table includes aggregate data for companies reporting on Rule Chapter 945 Short Form for Large Groups. Note: Some of the lines are left blank because companies reporting on the Short form are not required to complete them.

 

Large Group Grand Totals
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	217,201		221,237		217,677
(2) Member Months During Year	2,616,191		2,650,709		2,584,485
(3) Number of Contracts issued during year	515		417		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$993,050,356	100%	$940,768,015	100%	$897,886,130	100%
(6) Claims Incurred	$852,629,952	86%	$801,402,932	85%	$789,976,449	88%
(7) Increase in Policy Reserves	($48,884)	0%	($985,535)	0%	$364,785	0%
(8) Administrative Expenses	$83,242,406	8%	$62,888,385	7%	$85,535,546	10%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$57,226,882	6%	$77,462,233	8%	$21,194,351	2%
(10a) Premium per Member Month [(5)/(2)]	$380		$353		$345
(10b) Premium Trend [(10a)/(10a prior year)-1]	8%		2%		11%
(11a) Claims per Member Month [(6)/(2)]	$326		$301		$304
(11b) Claims Trend [(11a)/(11a prior year)-1]	8%		-1%		14%
Source: Rule Chapter 945 Aggregate Totals for Long Form Large Group and Short Form Large Group Note: The Covered Lives total and the Contracts Issued total does not include companies reporting less than $2 million in premium. These companies are not required to report those figures.

 

Small Group
Aetna (Aetna Health Inc + Aetna Life Ins Co)
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	38,126		32,676		29,475
(2) Member Months During Year	438,629		344,457		389,951
(3) Number of Contracts issued during year	1,139		1,086		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		18		NA
(5) Premiums Earned	$123,583,562	100%	$101,100,176	100%	$115,707,032	100%
(6) Claims Incurred	$98,312,205	80%	$81,291,086	80%	$91,211,438	79%
(7) Increase in Policy Reserves	$573,223	0%	$0	0%	$0	0%
(8) Administrative Expenses	$16,755,125	14%	$13,667,350	14%	$18,276,200	16%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$7,943,009	6%	$6,141,740	6%	$6,219,394	5%
(10a) Premium per Member Month [(5)/(2)]	$282		$294		$297
(10b) Premium Trend [(10a)/(10a prior year)-1]	-4%		-1%		-3%
(11a) Claims per Member Month [(6)/(2)]	$224		$236		$234
(11b) Claims Trend [(11a)/(11a prior year)-1]	-5%		1%		4%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Anthem Health Plans of ME Inc
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	51,704		63,921		82,548
(2) Member Months During Year	649,735		887,000		972,382
(3) Number of Contracts issued during year	3,947		2,366		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	450		705		NA
(5) Premiums Earned	$225,316,648	100%	$282,150,157	100%	$290,516,248	100%
(6) Claims Incurred	$184,386,716	82%	$223,493,550	79%	$230,355,139	79%
(7) Increase in Policy Reserves	($1,143)	0%	$0	0%	$0	0%
(8) Administrative Expenses	$29,112,559	13%	$32,035,552	11%	$31,553,192	11%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$11,818,516	5%	$26,621,055	9%	$28,607,917	10%
(10a) Premium per Member Month [(5)/(2)]	$347		$318		$299
(10b) Premium Trend [(10a)/(10a prior year)-1]	9%		6%		2%
(11a) Claims per Member Month [(6)/(2)]	$284		$252		$237
(11b) Claims Trend [(11a)/(11a prior year)-1]	13%		6%		3%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Harvard Pilgrim Health Care (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	11,091		10,071		5,173
(2) Member Months During Year	137,342		111,700		31,239
(3) Number of Contracts issued during year	1,728		386		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	3		0		NA
(5) Premiums Earned	$50,838,450	100%	$36,721,885	100%	$10,633,046	100%
(6) Claims Incurred	$43,811,855	86%	$33,655,657	92%	$9,652,224	91%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$6,592,694	13%	$5,522,315	15%	$1,603,576	15%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$433,901	1%	($2,456,087)	-7%	($622,754)	-6%
(10a) Premium per Member Month [(5)/(2)]	$370		$329		$340
(10b) Premium Trend [(10a)/(10a prior year)-1]	13%		-3%		32%
(11a) Claims per Member Month [(6)/(2)]	$319		$301		$309
(11b) Claims Trend [(11a)/(11a prior year)-1]	6%		-2%		58%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Mega Life & Health Ins Co
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	2,115		2,561		3,143
(2) Member Months During Year	27,143		33,142		42,561
(3) Number of Contracts issued during year	7		29		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		18		NA
(5) Premiums Earned	$5,475,463	100%	$7,281,554	100%	$9,355,669	100%
(6) Claims Incurred	$3,374,753	62%	$4,007,361	55%	$4,104,251	44%
(7) Increase in Policy Reserves	($241,361)	-4%	($979,968)	-13%	($1,356,129)	-14%
(8) Administrative Expenses	$2,320,873	42%	$2,878,305	40%	$3,560,193	38%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$21,198	0%	$1,375,856	19%	$3,047,354	33%
(10a) Premium per Member Month [(5)/(2)]	$202		$220		$220
(10b) Premium Trend [(10a)/(10a prior year)-1]	-8%		0%		-19%
(11a) Claims per Member Month [(6)/(2)]	$124		$121		$96
(11b) Claims Trend [(11a)/(11a prior year)-1]	3%		25%		-44%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
United Healthcare Ins Co
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	498		571		98
(2) Member Months During Year	6,175		3,498		1,352
(3) Number of Contracts issued during year	6		31		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		NA
(5) Premiums Earned	$1,723,528	100%	$1,165,258	100%	$180,041	100%
(6) Claims Incurred	$1,157,489	67%	$919,863	79%	$314,090	174%
(7) Increase in Policy Reserves	$18,156	1%	$13,409	1%	$4,427	2%
(8) Administrative Expenses	$413,647	24%	$279,662	24%	$43,210	24%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$134,236	8%	($47,676)	-4%	($181,686)	-101%
(10a) Premium per Member Month [(5)/(2)]	$279		$333		$133
(10b) Premium Trend [(10a)/(10a prior year)-1]	-16%		150%		-6%
(11a) Claims per Member Month [(6)/(2)]	$187		$263		$232
(11b) Claims Trend [(11a)/(11a prior year)-1]	-29%		13%		-63%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
All Other Companies
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31
(2) Member Months During Year
(3) Number of Contracts issued during year
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days
(5) Premiums Earned	$1,572,883	100%	$1,712,030	100%	$3,584,974	100%
(6) Claims Incurred	$1,026,661	65%	$1,762,301	103%	$2,217,328	62%
(7) Increase in Policy Reserves	($165,817)	-11%	$10,746	1%	$248,136	7%
(8) Administrative Expenses	$490,322	31%	$444,879	26%	$648,856	18%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$221,717	14%	($505,897)	-30%	$470,653	13%
(10a) Premium per Member Month [(5)/(2)]
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals for companies who are not displayed in the tables above. In addition, this table includes aggregate data for companies reporting on Rule Chapter 945 Short Form for Large Groups. Note: Some of the lines are left blank because companies reporting on the Short form are not required to complete them.

 

Small Group Grand Totals
Note: The Covered Lives total does not include all other companies as reporting is not required for companies reporting less than $2 million in premium.
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	103,534		109,800		120,437
(2) Member Months During Year	1,259,024		1,379,797		1,437,485
(3) Number of Contracts issued during year	6,827		3,898		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	453		741		NA
(5) Premiums Earned	$408,510,534	100%	$430,131,060	100%	$429,977,010	100%
(6) Claims Incurred	$332,069,679	81%	$345,129,818	80%	$337,854,470	79%
(7) Increase in Policy Reserves	$183,058	0%	($955,813)	0%	($1,103,566)	0%
(8) Administrative Expenses	$55,685,040	14%	$54,828,064	13%	$55,685,227	13%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$20,572,757	5%	$31,128,991	7%	$37,540,878	9%
(10a) Premium per Member Month [(5)/(2)]	$324		$308		$297
(10b) Premium Trend [(10a)/(10a prior year)-1]	5%		4%		1%
(11a) Claims per Member Month [(6)/(2)]	$264		$247		$232
(11b) Claims Trend [(11a)/(11a prior year)-1]	7%		6%		2%
Source: Rule Chapter 945 Aggregate Long Form Small Group and Dirigo Small Group Totals. Note: The Covered Lives total, the Contracts Issued total, and the total number of contracts issued during the year covering policyholders that were uninsured for the prior 90 days does not include companies reporting less than $2 million in premium. These companies are not required to report those figures.

 

Individual
Aetna (Aetna Health Inc + Aetna Life Ins Co)
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	45		69		75
(2) Member Months During Year	593		781		913
(3) Number of Contracts issued during year	0		0		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		NA
(5) Premiums Earned	$130,832	100%	$104,911	100%	$139,948	100%
(6) Claims Incurred	$361,754	277%	$242,192	231%	$301,889	216%
(7) Increase in Policy Reserves	($20,398)	-16%	($79,602)	-76%	$0	0%
(8) Administrative Expenses	$20,408	16%	$14,105	13%	$25,089	18%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($230,932)	-177%	($71,784)	-68%	($187,030)	-134%
(10a) Premium per Member Month [(5)/(2)]	$221		$134		$153
(10b) Premium Trend [(10a)/(10a prior year)-1]	65%		-12%		-83%
(11a) Claims per Member Month [(6)/(2)]	$610		$310		$331
(11b) Claims Trend [(11a)/(11a prior year)-1]	97%		-6%		-95%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
Anthem Health Plans of ME Inc
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	21,290		30,456		34,435
(2) Member Months During Year	264,312		346,568		417,991
(3) Number of Contracts issued during year	636		2,359		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	226		1,537		NA
(5) Premiums Earned	$67,172,619	100%	$108,526,567	100%	$94,706,405	100%
(6) Claims Incurred	$56,806,645	85%	$95,656,592	88%	$85,467,276	90%
(7) Increase in Policy Reserves	($3,285)	0%	$0	0%	$0	0%
(8) Administrative Expenses	$6,738,661	10%	$12,292,280	11%	$14,002,035	15%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$3,630,598	5%	$577,695	1%	($4,762,906)	-5%
(10a) Premium per Member Month [(5)/(2)]	$254		$313		$227
(10b) Premium Trend [(10a)/(10a prior year)-1]	-19%		38%		22%
(11a) Claims per Member Month [(6)/(2)]	$215		$276		$204
(11b) Claims Trend [(11a)/(11a prior year)-1]	-22%		35%		21%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co)
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	13		15		16
(2) Member Months During Year	176		184		184
(3) Number of Contracts issued during year	0		0		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		NA
(5) Premiums Earned	$64,462	100%	$77,643	100%	$229,002	100%
(6) Claims Incurred	$42,601	66%	$115,944	149%	$174,390	76%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$0	0%	$6,165	8%	$16,218	7%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$21,861	34%	$44,466	57%	$38,394	17%
(10a) Premium per Member Month [(5)/(2)]	$366		$422		$1,245
(10b) Premium Trend [(10a)/(10a prior year)-1]	-13%		-66%		6%
(11a) Claims per Member Month [(6)/(2)]	$242		$630		$948
(11b) Claims Trend [(11a)/(11a prior year)-1]	-62%		-34%		44%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
Harvard Pilgrim (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company)
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	7,821		6		14
(2) Member Months During Year	106,165		150		160
(3) Number of Contracts issued during year	4,992		0		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days			0		NA
(5) Premiums Earned	$55,079,470	100%	$169,620	100%	$182,309	100%
(6) Claims Incurred	$49,853,050	91%	$505,841	298%	$409,678	225%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$5,218,193	9%	$7,239	4%	$8,030	4%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$8,227	0%	($343,459)	-202%	($235,399)	-129%
(10a) Premium per Member Month [(5)/(2)]	$519		$1,131		$1,139
(10b) Premium Trend [(10a)/(10a prior year)-1]	-54%		-1%		-1%
(11a) Claims per Member Month [(6)/(2)]	$470		$3,372		$2,560
(11b) Claims Trend [(11a)/(11a prior year)-1]	-86%		32%		-27%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals. Note: (4) was left blank on the report.

 

Individual
Mega Life & Health Ins Co
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	11,285		9,757		6,797
(2) Member Months During Year	123,703		97,663		66,697
(3) Number of Contracts issued during year	2,661		3,646		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		1,716		NA
(5) Premiums Earned	$21,549,601	100%	$16,418,568	100%	$11,051,864	100%
(6) Claims Incurred	$13,365,760	62%	$8,708,246	53%	$4,165,029	38%
(7) Increase in Policy Reserves	$1,477,425	7%	$1,460,257	9%	$1,325,566	12%
(8) Administrative Expenses	$9,135,343	42%	$6,413,699	39%	$4,199,643	38%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($2,428,927)	-11%	($163,634)	-1%	$1,361,625	12%
(10a) Premium per Member Month [(5)/(2)]	$174		$168		$166
(10b) Premium Trend [(10a)/(10a prior year)-1]	4%		1%		-25%
(11a) Claims per Member Month [(6)/(2)]	$108		$89		$62
(11b) Claims Trend [(11a)/(11a prior year)-1]	21%		43%		-35%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
All other companies
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31
(2) Member Months During Year
(3) Number of Contracts issued during year
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days
(5) Premiums Earned	$3,817,188	100%	$4,437,726	100%	$3,937,945	100%
(6) Claims Incurred	$2,740,510	72%	$2,898,343	65%	$3,190,363	81%
(7) Increase in Policy Reserves	$64,372	2%	($472,076)	-11%	$55,980	1%
(8) Administrative Expenses	$859,900	23%	$1,172,739	26%	$1,014,924	26%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$152,406	4%	$838,720	19%	($323,321)	-8%
(10a) Premium per Member Month [(5)/(2)]
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual for companies who are not displayed in the tables above. In addition, this table includes aggregate data for companies reporting on Rule Chapter 945 Short Form for Individual and Dirigo Individual.

 

Individual Grand Totals
Insurer	2008		2007		2006
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	40,454		40,303		41,337
(2) Member Months During Year	494,949		445,346		485,945
(3) Number of Contracts issued during year	8,289		6,005		NA
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	226		3,253		NA
(5) Premiums Earned	$147,814,172	100%	$129,735,035	100%	$110,247,473	100%
(6) Claims Incurred	$123,710,320	84%	$108,127,157	83%	$93,708,625	85%
(7) Increase in Policy Reserves	$1,518,114	1%	$908,579	1%	$1,381,546	1%
(8) Administrative Expenses	$21,972,505	15%	$19,906,227	15%	$19,265,939	17%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$613,233	0%	$882,004	1%	($4,108,637)	-4%
(10a) Premium per Member Month [(5)/(2)]	$299		$281		$219
(10b) Premium Trend [(10a)/(10a prior year)-1]	6%		29%		15%
(11a) Claims per Member Month [(6)/(2)]	$250		$236		$186
(11b) Claims Trend [(11a)/(11a prior year)-1]	6%		27%		12%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals and Rule Chapter 945 Short Form Individual and Dirigo Individual Totals for Premiums Earned, Claims Incurred, Increase in Policy Reserves, Administrative Expenses, and Underwriting Gain or Loss. Note: The Covered Lives, the Contracts Issued, and the Number of Contracts Covering Previously Uninsured totals do not include companies reporting less than $2 million in premium. These companies are not required to report those figures.

 

 

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