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2011 STATEMENT OF REVENUE AND EXPENSES - 004
13627 - SelectCare of ME Inc

Line Uncovered Current Year Total Current Year Total Prior Year
01 Member months   0 0
02 Net premium income (including $0 non-health premium income)   0 0
03 Change in unearned premium reserves and reserve for rate credits   0 0
04 Fee-for-service (net of $0 medical expenses)   0 0
05 Risk revenue   0 0
06 Aggregate write-ins for other health care related revenues   0 0
07 Aggregate write-ins for other non-health revenues   0 0
08 Total revenues   0 0
09 Hospital/medical benefits (hospital and medical) 0 0 0
10 Other professional services (hospital and medical) 0 0 0
11 Outside referrals (hospital and medical) 0 0 0
12 Emergency room and out-of-area (hospital and medical) 0 0 0
13 Prescription drugs (hospital and medical) 0 0 0
14 Aggregate write-ins for other hospital and medical (hospital and medical) 0 0 0
15 Incentive pool, withhold adjustments and bonus amounts (hospital and medical) 0 0 0
16 Subtotal (hospital and medical) 0 0 0
17 Net reinsurance recoveries (less) 0 0 0
18 Total hospital and medical (less) 0 0 0
19 Non-health claims (net) (less) 0 0 0
20 Claims adjustment expenses, including $0 cost containment expenses (less) 0 0 0
21 General administrative expenses (less) 2,853 2,739 697
22 Increase in reserves for life and accident and health contracts (including $0 increase in reserves for life only) (less) 0 0 0
23 Total underwriting deductions 2,853 2,739 697
24 Net underwriting gain or (loss)   -2,739 -697
25 Net investment income earned 1,283 1,283 2,018
26 Net realized capital gains or (losses) less capital gains tax of $0 0 0 0
27 Net investment gains or (losses) 1,283 1,283 2,018
28 Net gain or (loss) from agents' or premium balances charged off [(amount recovered $0 (amount charged off $0] 0 0 0
29 Aggregate write-ins for other income or expenses 0 0 0
30 Net income or (loss), after capital gains tax and before all other federal income taxes   -1,456 1,321
31 Federal and foreign income taxes incurred   -512 463
32 Net income (loss)   -944 858
Details of Write-Ins
0601     0 0
0602     0 0
0603     0 0
0699     0 0
0701     0 0
0702     0 0
0703     0 0
0799     0 0
1401   0 0 0
1402   0 0 0
1403   0 0 0
1499   0 0 0
2901   0 0 0
2902   0 0 0
2903   0 0 0
2999   0 0 0

 

2011 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
13627 - SelectCare of ME Inc

Line Current Year Prior Year
33 Capital and surplus prior reporting year 1,522,037 1,521,179
34 Net income or (loss) from Line 32 -944 858
35 Change in valuation basis of aggregate policy and claim reserves 0 0
36 Change in net unrealized capital gains (losses) less capital gains tax of $0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 0 0
38 Change in net deferred income tax 0 0
39 Change in nonadmitted assets 0 0
40 Change in unauthorized reinsurance 0 0
41 Change in treasury stock 0 0
42 Change in surplus notes 0 0
43 Cumulative effect of changes in accounting principles 0 0
44.1 Paid in (capital changes) 0 0
44.2 Transferred from surplus (stock dividend) (capital changes) 0 0
44.3 Transferred to surplus (capital changes) 0 0
45.1 Paid in (surplus adjustments) 0 0
45.2 Transferred to capital (stock dividend) (surplus adjustments) 0 0
45.3 Transferred from capital (surplus adjustments) 0 0
46 Dividends to stockholders 0 0
47 Aggregate write-ins for gains or (losses) in surplus 0 0
48 Net change in capital and surplus -944 858
49 Capital and surplus end of reporting year 1,521,094 1,522,037
Details of Write-Ins
4799   0 0

 

Last Updated: August 15, 2012