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2010 LIABILITIES, CAPITAL AND SURPLUS - 003
12545 - Martins Point Generations LLC
Quarter 3

Line Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 6,328,288 0 6,328,288 2,582,112
02 Accrued medical incentive pool and bonus amounts 0 0 0 0
03 Unpaid claims adjustment expenses 209,464 0 209,464 81,338
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 258,059 0 258,059 171,763
09 General expenses due or accrued 235,464 0 235,464 252,928
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 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 564,796 0 564,796 522,212
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 1,117,881 0 1,117,881 239,423
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) 8,713,952 0 8,713,952 3,849,776
24 Aggregate write-ins for special surplus funds     0 0
25 Common capital stock     0 0
26 Preferred capital stock     0 0
27 Gross paid in and contributed surplus     10,000,000 6,000,000
28 Surplus notes     0 0
29 Aggregate write-ins for other than special surplus funds     0 0
30 Unassigned funds (surplus)     -7,002,864 -3,789,615
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     2,997,136 2,210,385
33 Total liabilities, capital and surplus     11,711,088 6,060,161
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