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2009 LIABILITIES, CAPITAL AND SURPLUS - 003
95447 - Cigna Healthcare of ME Inc
Quarter 2

Line Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 459,852 1,153 461,005 642,458
02 Accrued medical incentive pool and bonus amounts 16,201 0 16,201 366,034
03 Unpaid claims adjustment expenses 10,116 25 10,141 15,704
04 Aggregate health policy reserves 0 0 0 0
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 28 0 28 0
09 General expenses due or accrued 10,000 0 10,000 15,000
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 100,296 0 100,296 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 0 828
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 576,443 0 576,443 576,388
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) 126,002 0 126,002 93,295
22 Total liabilities (Lines 1 to 21) 1,298,938 1,178 1,300,116 1,709,707
23 Aggregate write-ins for special surplus funds     0 0
24 Common capital stock     100 100
25 Preferred capital stock     0 0
26 Gross paid in and contributed surplus     2,971,401 2,971,401
27 Surplus notes     0 0
28 Aggregate write-ins for other than special surplus funds     0 0
29 Unassigned funds (surplus)     5,211,447 4,822,333
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     8,182,948 7,793,834
32 Total liabilities, capital and surplus     9,483,064 9,503,541
Details of Write-Ins
2101 COMMISSION PAYABLE 7,576 0 7,576 12,929
2102 CREDIT BALANCES DUE POLICYHOLDERS 3,955 0 3,955 13,100
2103 CURRENT SIT PAYABLE 109,804 0 109,804 62,313
2104 ESCHEAT LIABILITY 4,667 0 4,667 4,953
2199   126,002 0 126,002 93,295
2399       0 0
2801       0 0
2899       0 0

Last Updated: September 27, 2010