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2010 LIABILITIES, CAPITAL AND SURPLUS - 003
12151 - Arcadian Hlth Plan Inc

Line Covered Current Year Uncovered Current Year Total Current Year Total Prior Year
01 Claims unpaid (less $49720 reinsurance ceded) 30,655,149 3,493,300 34,148,449 28,201,803
02 Accrued medical incentive pool and bonus amounts 205,768 0 205,768 292,785
03 Unpaid claims adjustment expenses 925,026 0 925,026 667,366
04 Aggregate health policy reserves 0 0 0 0
05 Aggregate life policy reserves 0 0 0 0
06 Property/casualty unearned premium reserves 0 0 0 0
07 Aggregate health claim reserves 0 0 0 0
08 Premiums received in advance 0 0 0 0
09 General expenses due or accrued 8,602,040 0 8,602,040 5,259,408
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 222,921
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 225,746 0 225,746 177,846
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 2,090,058 0 2,090,058 953,735
16 Derivatives 0 0 0 0
17 Payable for securities 0 0 0 0
18 Payable for securities lending 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers and $0 unauthorized reinsurers) 0 0 0 0
20 Reinsurance in unauthorized companies 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 0 0 0 0
22 Liability for amounts held under uninsured plans 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 0 0 0 0
24 Total liabilities (Lines 1 to 23) 42,703,787 3,493,300 46,197,087 35,775,864
25 Aggregate write-ins for special surplus funds     0 0
26 Common capital stock     600,000 600,000
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     34,696,777 34,696,777
29 Surplus notes     0 0
30 Aggregate write-ins for other than special surplus funds     0 0
31 Unassigned funds (surplus)     16,547,932 9,886,301
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost)     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost)     0 0
33 Total capital and surplus     51,844,709 45,183,078
34 Total liabilities, capital and surplus     98,041,796 80,958,942
Details of Write-Ins
2399   0 0 0 0
2599       0 0
3099       0 0

Last Updated: September 27, 2010