|
Line |
Uncovered Current Year to Date |
Total Current Year to Date |
Total Prior Year to Date |
Total Prior Year Ended December 31 |
| 01 |
Member months |
|
82,627 |
72,851 |
303,299 |
| 02 |
Net premium income (including $0 non-health premium
income) |
|
63,252,652 |
51,926,895 |
230,337,506 |
| 03 |
Change in unearned premium reserves and reserve for
rate credits |
|
0 |
0 |
0 |
| 04 |
Fee-for-service (net of $0 medical expenses) |
|
0 |
0 |
0 |
| 05 |
Risk revenue |
|
0 |
0 |
0 |
| 06 |
Aggregate write-ins for other health care related
revenues |
|
0 |
0 |
0 |
| 07 |
Aggregate write-ins for other non-health revenues |
|
0 |
0 |
0 |
| 08 |
Total revenues |
|
63,252,652 |
51,926,895 |
230,337,506 |
| 09 |
Hospital/medical benefits (hospital and medical) |
0 |
30,375,687 |
25,879,333 |
109,654,900 |
| 10 |
Other professional services (hospital and
medical) |
0 |
5,375,173 |
3,437,102 |
19,234,596 |
| 11 |
Outside referrals (hospital and medical) |
8,124,928 |
8,124,928 |
6,443,129 |
29,330,632 |
| 12 |
Emergency room and out-of-area (hospital and
medical) |
582,359 |
1,361,837 |
1,172,305 |
4,916,170 |
| 13 |
Prescription drugs (hospital and medical) |
0 |
7,882,888 |
6,224,607 |
25,516,997 |
| 14 |
Aggregate write-ins for other hospital and medical
(hospital and medical) |
0 |
0 |
0 |
0 |
| 15 |
Incentive pool, withhold adjustments and bonus
amounts (hospital and medical) |
0 |
133,425 |
95,368 |
290,764 |
| 16 |
Subtotal (hospital and medical) |
8,707,287 |
53,253,938 |
43,251,844 |
188,944,059 |
| 17 |
Net reinsurance recoveries (less) |
0 |
451,516 |
128,610 |
1,796,723 |
| 18 |
Total hospital and medical (less) |
8,707,287 |
52,802,422 |
43,123,234 |
187,147,336 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses, including $0 cost
containment expenses (less) |
0 |
2,122,843 |
4,156,891 |
7,674,579 |
| 21 |
General administrative expenses (less) |
0 |
6,428,446 |
8,792,924 |
33,053,771 |
| 22 |
Increase in reserves for life and accident and
health contracts (including $0 increase in reserves for life only)
(less) |
0 |
0 |
0 |
0 |
| 23 |
Total underwriting deductions |
8,707,287 |
61,353,711 |
56,073,049 |
227,875,686 |
| 24 |
Net underwriting gain or (loss) |
|
1,898,941 |
-4,146,154 |
2,461,820 |
| 25 |
Net investment income earned |
0 |
463,284 |
698,798 |
2,640,650 |
| 26 |
Net realized capital gains (losses) less capital
gains tax of $0 |
0 |
66,491 |
57,207 |
95,638 |
| 27 |
Net investment gains or (losses) |
0 |
529,775 |
756,005 |
2,736,288 |
| 28 |
Net gain or (loss) from agents' or premium balances
charged off [(amount recovered $0 (amount charged off $0] |
0 |
0 |
0 |
0 |
| 29 |
Aggregate write-ins for other income or expenses |
0 |
0 |
0 |
0 |
| 30 |
Net income or (loss) after capital gains tax and
before all other federal income taxes |
|
2,428,716 |
-3,390,149 |
5,198,108 |
| 31 |
Federal and foreign income taxes incurred |
|
0 |
0 |
1,222,130 |
| 32 |
Net income (loss) |
|
2,428,716 |
-3,390,149 |
3,975,978 |
|
Details of Write-Ins |
| 0699 |
|
|
0 |
0 |
0 |
| 0799 |
|
|
0 |
0 |
0 |
| 1401 |
VISION |
0 |
0 |
0 |
0 |
| 1499 |
|
0 |
0 |
0 |
0 |
| 2999 |
|
0 |
0 |
0 |
0 |
2009 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 Ended December 31 |
| 33 |
Capital and surplus prior reporting year |
30,667,137 |
21,318,801 |
21,318,801 |
| 34 |
Net income or (loss) from Line 32 |
2,428,716 |
-3,390,149 |
3,975,978 |
| 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 |
460,586 |
-596,794 |
1,961,492 |
| 37 |
Change in net unrealized foreign exchange capital
gain or (loss) |
0 |
0 |
0 |
| 38 |
Change in net deferred income tax |
0 |
0 |
2,085,991 |
| 39 |
Change in nonadmitted assets |
1,274,105 |
2,116,007 |
1,324,875 |
| 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 |
0 |
| 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 |
4,163,407 |
-1,870,936 |
9,348,336 |
| 49 |
Capital and surplus end of reporting period |
34,830,544 |
19,447,865 |
30,667,137 |
|
Details of Write-Ins |
| 4701 |
2006 AUDIT ADJUSTMENTS |
0 |
0 |
0 |
| 4702 |
ADJUSTMENT FOR 2006 VARIANCE - P3, L31,
C3 & P5, L48, C1 |
0 |
0 |
0 |
| 4799 |
|
0 |
0 |
0 |
|
|
