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2011 STATEMENT OF REVENUE AND EXPENSES - 004
13627 - SelectCare of ME Inc
Quarter 1

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   0 0 0
02 Net premium income (including $0 non-health premium income)   0 0 0
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   0 0 0
09 Hospital/medical benefits (hospital and medical) 0 0 0 0
10 Other professional services (hospital and medical) 0 0 0 0
11 Outside referrals (hospital and medical) 0 0 0 0
12 Emergency room and out-of-area (hospital and medical) 0 0 0 0
13 Prescription drugs (hospital and medical) 0 0 0 0
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 0 0 0
16 Subtotal (hospital and medical) 0 0 0 0
17 Net reinsurance recoveries (less) 0 0 0 0
18 Total hospital and medical (less) 0 0 0 0
19 Non-health claims (net) (less) 0 0 0 0
20 Claims adjustment expenses, including $0 cost containment expenses (less) 46 46 0 0
21 General administrative expenses (less) 214 214 697 697
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 260 260 697 697
24 Net underwriting gain or (loss)   -260 -697 -697
25 Net investment income earned 253 253 396 2,018
26 Net realized capital gains (losses) less capital gains tax of $0 0 0 0 0
27 Net investment gains or (losses) 253 253 396 2,018
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   -7 -301 1,321
31 Federal and foreign income taxes incurred   0 -105 463
32 Net income (loss)   -7 -196 858
Details of Write-Ins
0601     0 0 0
0602     0 0 0
0603     0 0 0
0699     0 0 0
0701     0 0 0
0702     0 0 0
0703     0 0 0
0799     0 0 0
1401   0 0 0 0
1402   0 0 0 0
1403   0 0 0 0
1499   0 0 0 0
2901   0 0 0 0
2902   0 0 0 0
2903   0 0 0 0
2999   0 0 0 0

 

2011 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
13627 - SelectCare of ME Inc
Quarter 1

Line Current Year to Date Prior Year to Date Prior Year Ended December 31
33 Capital and surplus prior reporting year 1,522,037 1,521,179 1,521,179
34 Net income or (loss) from Line 32 -7 -196 858
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 0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 0 0 0
38 Change in net deferred income tax 0 0 0
39 Change in nonadmitted assets 0 0 0
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 0 0 0
48 Net change in capital and surplus -7 -196 858
49 Capital and surplus end of reporting period 1,522,030 1,520,983 1,522,037
Details of Write-Ins
4701   0 0 0
4702   0 0 0
4703   0 0 0
4799   0 0 0

 

Last Updated: September 27, 2010