|
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 |
|
253,252 |
227,278 |
303,299 |
| 02 |
Net premium income (including $0 non-health premium
income) |
|
202,344,815 |
170,973,915 |
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 |
|
202,344,815 |
170,973,915 |
230,337,506 |
| 09 |
Hospital/medical benefits (hospital and medical) |
0 |
94,753,031 |
82,936,565 |
109,654,900 |
| 10 |
Other professional services (hospital and
medical) |
0 |
15,653,586 |
13,314,765 |
19,234,596 |
| 11 |
Outside referrals (hospital and medical) |
19,733,352 |
19,733,352 |
23,198,238 |
29,330,632 |
| 12 |
Emergency room and out-of-area (hospital and
medical) |
1,999,191 |
5,991,631 |
3,641,104 |
4,916,170 |
| 13 |
Prescription drugs (hospital and medical) |
0 |
23,015,754 |
19,489,338 |
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 |
525,658 |
213,342 |
290,764 |
| 16 |
Subtotal (hospital and medical) |
21,732,543 |
159,673,012 |
142,793,352 |
188,944,059 |
| 17 |
Net reinsurance recoveries (less) |
0 |
1,223,620 |
1,318,035 |
1,796,723 |
| 18 |
Total hospital and medical (less) |
21,732,543 |
158,449,392 |
141,475,317 |
187,147,336 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses, including $0 cost
containment expenses (less) |
0 |
5,838,254 |
3,713,532 |
7,674,579 |
| 21 |
General administrative expenses (less) |
0 |
25,411,559 |
24,405,514 |
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 |
21,732,543 |
189,699,205 |
169,594,363 |
227,875,686 |
| 24 |
Net underwriting gain or (loss) |
|
12,645,610 |
1,379,552 |
2,461,820 |
| 25 |
Net investment income earned |
0 |
1,883,669 |
2,026,964 |
2,640,650 |
| 26 |
Net realized capital gains (losses) less capital
gains tax of $0 |
0 |
38,200 |
87,636 |
95,638 |
| 27 |
Net investment gains or (losses) |
0 |
1,921,869 |
2,114,600 |
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 |
|
14,567,479 |
3,494,152 |
5,198,108 |
| 31 |
Federal and foreign income taxes incurred |
|
4,157,614 |
0 |
1,222,130 |
| 32 |
Net income (loss) |
|
10,409,865 |
3,494,152 |
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 3 |
|
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 |
10,409,865 |
3,494,152 |
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 |
2,993,456 |
348,423 |
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 |
3,584,916 |
2,085,991 |
| 39 |
Change in nonadmitted assets |
1,330,937 |
1,014,850 |
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 |
330,400 |
0 |
0 |
| 48 |
Net change in capital and surplus |
15,064,658 |
8,442,341 |
9,348,336 |
| 49 |
Capital and surplus end of reporting period |
45,731,795 |
29,761,142 |
30,667,137 |
|
Details of Write-Ins |
| 4701 |
2006 AUDIT ADJUSTMENTS |
330,400 |
0 |
0 |
| 4702 |
ADJUSTMENT FOR 2006 VARIANCE - P3, L31,
C3 & P5, L48, C1 |
0 |
0 |
0 |
| 4799 |
|
330,400 |
0 |
0 |
|
|
