|
Line |
Uncovered Current Year to
Date |
Total Current Year to Date |
Total Prior Year to Date |
| 01 |
Member months |
|
51,247 |
20,389 |
| 02 |
Net premium income (including
$0 non-health premium income) |
|
34,347,231 |
14,504,788 |
| 03 |
Change in unearned premium
reserves and reserve for rate credits |
|
0 |
0 |
| 04 |
Fee-for-service (net of $0
medical expenses) |
|
0 |
0 |
| 05 |
Risk revenue |
|
0 |
0 |
| 06 |
Aggregate write-ins for other
health care related revenues |
|
0 |
0 |
| 07 |
Aggregate write-ins for other
non-health revenues |
|
0 |
0 |
| 08 |
Total revenues |
|
34,347,231 |
14,504,788 |
| 09 |
Hospital/medical benefits
(hospital and medical) |
0 |
16,898,868 |
6,611,137 |
| 10 |
Other professional services
(hospital and medical) |
0 |
1,810,398 |
800,303 |
| 11 |
Outside referrals (hospital
and medical) |
3,672,552 |
3,672,552 |
1,858,197 |
| 12 |
Emergency room and out-of-area
(hospital and medical) |
229,646 |
464,005 |
120,126 |
| 13 |
Prescription drugs (hospital
and medical) |
0 |
2,974,955 |
784,619 |
| 14 |
Aggregate write-ins for other
hospital and medical (hospital and medical) |
0 |
0 |
0 |
| 15 |
Incentive pool, withhold
adjustments and bonus amounts (hospital and medical) |
0 |
0 |
0 |
| 16 |
Subtotal (hospital and medical) |
3,902,198 |
25,820,778 |
10,174,382 |
| 17 |
Net reinsurance recoveries
(less) |
0 |
22,164 |
0 |
| 18 |
Total hospital and medical
(less) |
3,902,198 |
25,798,614 |
10,174,382 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses,
including $0 cost containment expenses (less) |
0 |
3,320,371 |
1,094,759 |
| 21 |
General administrative expenses
(less) |
0 |
10,407,247 |
4,306,401 |
| 22 |
Increase in reserves for
life and accident and health contracts (including $0 increase
in reserves for life only) (less) |
0 |
0 |
0 |
| 23 |
Total underwriting deductions |
3,902,198 |
39,526,232 |
15,575,542 |
| 24 |
Net underwriting gain or
(loss) |
|
-5,179,001 |
-1,070,754 |
| 25 |
Net investment income earned |
0 |
478,365 |
111,735 |
| 26 |
Net realized capital gains
(losses) less capital gains tax of $0 |
0 |
0 |
0 |
| 27 |
Net investment gains or (losses) |
0 |
478,365 |
111,735 |
| 28 |
Net gain or (loss) from agents'
or premium balances charged off [(amount recovered $0
(amount charged off $0] |
0 |
0 |
0 |
| 29 |
Aggregate write-ins for other
income or expenses |
0 |
0 |
0 |
| 30 |
Net income or (loss) after
capital gains tax and before all other federal income
taxes |
|
-4,700,636 |
-959,019 |
| 31 |
Federal and foreign income
taxes incurred |
|
0 |
0 |
| 32 |
Net income (loss) |
|
-4,700,636 |
-959,019 |
|
Details of Write-Ins |
| 0699 |
|
|
0 |
0 |
| 0799 |
|
|
0 |
0 |
| 1499 |
|
0 |
0 |
0 |
| 2999 |
|
0 |
0 |
0 |
2007 STATEMENT OF REVENUE AND EXPENSES
(Continued) - 005
12151 - Arcadian Health Plan Inc
Quarter 1 |
|
Line |
Current Year to Date |
Prior Year to Date |
Prior Year |
| 33 |
Capital and surplus
prior reporting year |
7,382,288 |
8,332,572 |
8,332,572 |
| 34 |
Net income or (loss)
from Line 32 |
-4,700,636 |
-959,019 |
-5,083,285 |
| 35 |
Change in valuation
basis of aggregate policy and claim reserves |
0 |
0 |
0 |
| 36 |
Change in net unrealized
capital gains (losses) less capital gains tax
of $0 |
152,997 |
-560,807 |
-1,412,014 |
| 37 |
Change in net unrealized
foreign exchange capital gain or (loss) |
0 |
0 |
0 |
| 38 |
Change in net deferred
income tax |
0 |
0 |
0 |
| 39 |
Change in nonadmitted
assets |
273,448 |
-4,776,372 |
-911,845 |
| 40 |
Change in unauthorized
reinsurance |
0 |
0 |
0 |
| 41 |
Change in treasury
stock |
0 |
0 |
0 |
| 42 |
Change in surplus
notes |
0 |
0 |
0 |
| 43 |
Cumulative effect
of changes in accounting principles |
0 |
0 |
0 |
| 44.1 |
Paid in (capital
changes) |
0 |
0 |
563,430 |
| 44.2 |
Transferred from
surplus (stock dividend) (capital changes) |
0 |
0 |
0 |
| 44.3 |
Transferred to surplus
(capital changes) |
0 |
0 |
0 |
| 45.1 |
Paid in (surplus
adjustments) |
7,500,000 |
0 |
5,893,546 |
| 45.2 |
Transferred to capital
(stock dividend) (surplus adjustments) |
0 |
0 |
0 |
| 45.3 |
Transferred from
capital (surplus adjustments) |
0 |
0 |
0 |
| 46 |
Dividends to stockholders |
0 |
0 |
0 |
| 47 |
Aggregate write-ins
for gains or (losses) in surplus |
0 |
0 |
0 |
| 48 |
Net change in capital
and surplus |
3,225,809 |
-6,296,198 |
-950,168 |
| 49 |
Capital and surplus
end of reporting period |
10,608,097 |
2,036,374 |
7,382,404 |
|
Details of Write-Ins |
| 4799 |
|
0 |
0 |
0 |
|
|
