|
Line |
Covered Current Period |
Uncovered Current Period |
Total Current Period |
Total Prior Year |
| 01 |
Claims unpaid (less $0 reinsurance
ceded) |
101,568,526 |
345,859 |
101,914,385 |
93,523,130 |
| 02 |
Accrued medical incentive
pool and bonus amounts |
0 |
0 |
0 |
0 |
| 03 |
Unpaid claims adjustment
expenses |
3,191,188 |
0 |
3,191,188 |
3,241,745 |
| 04 |
Aggregate health policy reserves |
57,514,727 |
0 |
57,514,727 |
75,703,424 |
| 05 |
Aggregate life policy reserves |
0 |
0 |
0 |
0 |
| 06 |
Property/casualty unearned
premium reserve |
0 |
0 |
0 |
0 |
| 07 |
Aggregate health claim reserves |
0 |
0 |
0 |
0 |
| 08 |
Premiums received in advance |
1,224,680 |
0 |
1,224,680 |
1,142,594 |
| 09 |
General expenses due or accrued |
27,113,526 |
0 |
27,113,526 |
31,534,108 |
| 10.1 |
Current federal and foreign
income tax payable and interest thereon (including $0
on realized capital gains (losses)) |
7,868,247 |
0 |
7,868,247 |
842,445 |
| 10.2 |
Net deferred tax liability |
0 |
0 |
0 |
0 |
| 11 |
Ceded reinsurance premiums
payable |
0 |
0 |
0 |
0 |
| 12 |
Amounts withheld or retained
for the account of others |
531,858 |
0 |
531,858 |
635,519 |
| 13 |
Remittances and items not
allocated |
5,631,256 |
0 |
5,631,256 |
6,746,716 |
| 14 |
Borrowed money (including
$0 current) and interest thereon $0 (including $0 current) |
0 |
0 |
0 |
0 |
| 15 |
Amounts due to parent, subsidiaries
and affiliates |
99,671,095 |
0 |
99,671,095 |
91,027,784 |
| 16 |
Payable for securities |
0 |
0 |
0 |
0 |
| 17 |
Funds held under reinsurance
treaties with ($0 authorized reinsurers and $0 unauthorized
reinsurers) |
0 |
0 |
0 |
0 |
| 18 |
Reinsurance in unauthorized
companies |
0 |
0 |
0 |
0 |
| 19 |
Net adjustments in assets
and liabilities due to foreign exchange rates |
0 |
0 |
0 |
0 |
| 20 |
Liability for amounts held
under uninsured plans |
18,354,169 |
0 |
18,354,169 |
19,190,370 |
| 21 |
Aggregate write-ins for other
liabilities (including $1761987 current) |
2,721,087 |
0 |
2,721,087 |
2,811,246 |
| 22 |
Total liabilities (Lines
1 to 21) |
325,390,359 |
345,859 |
325,736,218 |
326,399,081 |
| 23 |
Aggregate write-ins for special
surplus funds |
|
|
0 |
0 |
| 24 |
Common capital stock |
|
|
2,500,000 |
2,500,000 |
| 25 |
Preferred capital stock |
|
|
0 |
0 |
| 26 |
Gross paid in and contributed
surplus |
|
|
120,652,900 |
120,652,900 |
| 27 |
Surplus notes |
|
|
0 |
0 |
| 28 |
Aggregate write-ins for other
than special surplus funds |
|
|
0 |
0 |
| 29 |
Unassigned funds (surplus) |
|
|
109,899,022 |
92,142,619 |
| 30.1 |
(1) shares common (value
included in common capital stock $0) (less treasury stock,
at cost) |
|
|
0 |
0 |
| 30.2 |
(1) shares preferred (value
included in preferred capital stock $0) (less treasury
stock, at cost) |
|
|
0 |
0 |
| 31 |
Total capital and surplus |
|
|
233,051,922 |
215,295,519 |
| 32 |
Total liabilities, capital
and surplus |
|
|
558,788,140 |
541,694,600 |
|
Details of Write-Ins |
| 2101 |
Other Liabilities |
2,503,588 |
0 |
2,503,588 |
2,629,322 |
| 2102 |
Accounts Payable - ITS |
217,499 |
0 |
217,499 |
181,924 |
| 2199 |
|
2,721,087 |
0 |
2,721,087 |
2,811,246 |
| 2399 |
|
|
|
0 |
0 |
| 2899 |
|
|
|
0 |
0 |
|
