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2010 LIABILITIES, CAPITAL AND SURPLUS - 003
13627 - SelectCare of ME Inc
Quarter 1

Line Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 0 0 0 0
02 Accrued medical incentive pool and bonus amounts 0 0 0 0
03 Unpaid claims adjustment expenses 0 0 0 0
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 0 0 0 0
09 General expenses due or accrued 0 131 131 196
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 530 530 635
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 0 1,290 1,290 593
16 Derivatives 0 0 0 0
17 Payable for securities 0 0 0 0
18 Funds held under reinsurance treaties with ($0 authorized reinsurers and $0 unauthorized reinsurers) 0 0 0 0
19 Reinsurance in unauthorized companies 0 0 0 0
20 Net adjustments in assets and liabilities due to foreign exchange rates 0 0 0 0
21 Liability for amounts held under uninsured plans 0 0 0 0
22 Aggregate write-ins for other liabilities (including $0 current) 0 0 0 0
23 Total liabilities (Lines 1 to 22) 0 1,951 1,951 1,424
24 Aggregate write-ins for special surplus funds     0 0
25 Common capital stock     1,000 1,000
26 Preferred capital stock     1,519,000 1,519,000
27 Gross paid in and contributed surplus     0 0
28 Surplus notes     0 0
29 Aggregate write-ins for other than special surplus funds     0 0
30 Unassigned funds (surplus)     983 1,180
31.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost)     0 0
31.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost)     0 0
32 Total capital and surplus     1,520,983 1,521,180
33 Total liabilities, capital and surplus     1,522,934 1,522,604
Details of Write-Ins
2201   0 0 0 0
2202   0 0 0 0
2203   0 0 0 0
2299   0 0 0 0
2401       0 0
2402       0 0
2403       0 0
2499       0 0
2901       0 0
2902       0 0
2903       0 0
2999       0 0

Last Updated: September 27, 2010