|
2007 STATEMENT OF REVENUE AND EXPENSES - 004
12545 - Martins Point Generations LLC
Quarter 1 |
|
Line |
Uncovered Current Year to
Date |
Total Current Year to Date |
Total Prior Year to Date |
| 01 |
Member months |
|
718 |
0 |
| 02 |
Net premium income (including
$0 non-health premium income) |
|
425,392 |
0 |
| 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 |
|
425,392 |
0 |
| 09 |
Hospital/medical benefits
(hospital and medical) |
0 |
324,725 |
0 |
| 10 |
Other professional services
(hospital and medical) |
0 |
0 |
0 |
| 11 |
Outside referrals (hospital
and medical) |
0 |
0 |
0 |
| 12 |
Emergency room and out-of-area
(hospital and medical) |
0 |
0 |
0 |
| 13 |
Prescription drugs (hospital
and medical) |
0 |
44,990 |
0 |
| 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) |
0 |
369,715 |
0 |
| 17 |
Net reinsurance recoveries
(less) |
0 |
0 |
0 |
| 18 |
Total hospital and medical
(less) |
0 |
369,715 |
0 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses,
including $2078 cost containment expenses (less) |
0 |
12,052 |
0 |
| 21 |
General administrative expenses
(less) |
0 |
500,304 |
0 |
| 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 |
0 |
882,071 |
0 |
| 24 |
Net underwriting gain or
(loss) |
|
-456,679 |
0 |
| 25 |
Net investment income earned |
0 |
28,186 |
0 |
| 26 |
Net realized capital gains
(losses) less capital gains tax of $0 |
0 |
0 |
0 |
| 27 |
Net investment gains or (losses) |
0 |
28,186 |
0 |
| 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 |
|
-428,493 |
0 |
| 31 |
Federal and foreign income
taxes incurred |
|
0 |
0 |
| 32 |
Net income (loss) |
|
-428,493 |
0 |
|
Details of Write-Ins |
| 0601 |
|
|
0 |
0 |
| 0602 |
|
|
0 |
0 |
| 0603 |
|
|
0 |
0 |
| 0699 |
|
|
0 |
0 |
| 0701 |
|
|
0 |
0 |
| 0702 |
|
|
0 |
0 |
| 0703 |
|
|
0 |
0 |
| 0799 |
|
|
0 |
0 |
| 1401 |
|
0 |
0 |
0 |
| 1402 |
|
0 |
0 |
0 |
| 1403 |
|
0 |
0 |
0 |
| 1499 |
|
0 |
0 |
0 |
| 2901 |
|
0 |
0 |
0 |
| 2902 |
|
0 |
0 |
0 |
| 2903 |
|
0 |
0 |
0 |
| 2999 |
|
0 |
0 |
0 |
2007 STATEMENT OF REVENUE AND EXPENSES
(Continued) - 005
12545 - Martins Point Generations LLC
Quarter 1 |
|
Line |
Current Year to Date |
Prior Year to Date |
Prior Year |
| 33 |
Capital and surplus
prior reporting year |
2,369,289 |
0 |
0 |
| 34 |
Net income or (loss)
from Line 32 |
-428,493 |
0 |
-630,711 |
| 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 |
0 |
0 |
0 |
| 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 |
0 |
0 |
0 |
| 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 |
3,000,000 |
| 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) |
0 |
0 |
0 |
| 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 |
-428,493 |
0 |
2,369,289 |
| 49 |
Capital and surplus
end of reporting period |
1,940,796 |
0 |
2,369,289 |
|
Details of Write-Ins |
| 4701 |
|
0 |
0 |
0 |
| 4702 |
|
0 |
0 |
0 |
| 4703 |
|
0 |
0 |
0 |
| 4799 |
|
0 |
0 |
0 |
|
|
Last Updated:
November 18, 2009
|
