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2009 LIABILITIES, CAPITAL AND SURPLUS - 003
95517 - Aetna Health Inc ME Corp
Quarter 1

Line Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 12,437,547 218,942 12,656,489 12,878,051
02 Accrued medical incentive pool and bonus amounts 0 0 0 0
03 Unpaid claims adjustment expenses 232,474 0 232,474 249,122
04 Aggregate health policy reserves 733,170 0 733,170 651,096
05 Aggregate life policy reserves 0 0 0 0
06 Property/casualty unearned premium reserve 0 0 0 0
07 Aggregate health claim reserves 192,051 0 192,051 210,678
08 Premiums received in advance 0 0 0 0
09 General expenses due or accrued 174,878 0 174,878 15,507
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 0
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 0 0 0 0
13 Remittances and items not allocated 0 0 0 0
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 1,059,639 0 1,059,639 2,928,761
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 0 0 0 0
21 Aggregate write-ins for other liabilities (including $0 current) 38,377 0 38,377 9,400,000
22 Total liabilities (Lines 1 to 21) 14,868,136 218,942 15,087,078 26,333,215
23 Aggregate write-ins for special surplus funds     0 0
24 Common capital stock     1,000,000 1,000,000
25 Preferred capital stock     0 0
26 Gross paid in and contributed surplus     9,700,000 9,700,000
27 Surplus notes     0 0
28 Aggregate write-ins for other than special surplus funds     0 0
29 Unassigned funds (surplus)     10,112,352 9,850,906
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     20,812,352 20,550,906
32 Total liabilities, capital and surplus     35,899,430 46,884,121
Details of Write-Ins
2101 Medicare Part D Catastrophic Coverage Payable 25,855 0 25,855 0
2102 CMS Risk Sharing Payable 8,496 0 8,496 0
2103 Medicare Part D Low Income Cost Share Payable 4,026 0 4,026 0
2104 Dividend Payable 0 0 0 9,400,000
2199   38,377 0 38,377 9,400,000
2399       0 0
2899       0 0

Last Updated: September 27, 2010