|
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 |
|
70,699 |
93,037 |
167,516 |
| 02 |
Net premium income (including $0 non-health premium
income) |
|
36,435,812 |
44,452,041 |
81,725,380 |
| 03 |
Change in unearned premium reserves and reserve for
rate credits |
|
13,750 |
14,979 |
13,810 |
| 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 |
|
36,449,562 |
44,467,020 |
81,739,190 |
| 09 |
Hospital/medical benefits (hospital and medical) |
345,269 |
23,125,361 |
30,471,684 |
57,370,051 |
| 10 |
Other professional services (hospital and
medical) |
0 |
0 |
0 |
0 |
| 11 |
Outside referrals (hospital and medical) |
351,531 |
351,531 |
292,197 |
854,311 |
| 12 |
Emergency room and out-of-area (hospital and
medical) |
46,167 |
1,538,915 |
1,673,187 |
3,038,017 |
| 13 |
Prescription drugs (hospital and medical) |
0 |
3,412,239 |
5,020,822 |
9,020,055 |
| 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) |
742,967 |
28,428,046 |
37,457,890 |
70,282,434 |
| 17 |
Net reinsurance recoveries (less) |
0 |
0 |
0 |
0 |
| 18 |
Total hospital and medical (less) |
742,967 |
28,428,046 |
37,457,890 |
70,282,434 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses, including $494799 cost
containment expenses (less) |
0 |
733,061 |
749,158 |
1,693,002 |
| 21 |
General administrative expenses (less) |
0 |
3,631,652 |
4,710,854 |
7,564,018 |
| 22 |
Increase in reserves for life and accident and
health contracts (including $0 increase in reserves for life only)
(less) |
0 |
164,748 |
-427,467 |
-661,728 |
| 23 |
Total underwriting deductions |
742,967 |
32,957,507 |
42,490,435 |
78,877,726 |
| 24 |
Net underwriting gain or (loss) |
|
3,492,055 |
1,976,585 |
2,861,464 |
| 25 |
Net investment income earned |
0 |
404,079 |
562,515 |
1,036,790 |
| 26 |
Net realized capital gains (losses) less capital
gains tax of $-39168 |
0 |
-16,955 |
242,079 |
458,722 |
| 27 |
Net investment gains or (losses) |
0 |
387,124 |
804,594 |
1,495,512 |
| 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 |
|
3,879,179 |
2,781,179 |
4,356,976 |
| 31 |
Federal and foreign income taxes incurred |
|
909,502 |
349,363 |
204,615 |
| 32 |
Net income (loss) |
|
2,969,677 |
2,431,816 |
4,152,361 |
|
Details of Write-Ins |
| 0699 |
|
|
0 |
0 |
0 |
| 0799 |
|
|
0 |
0 |
0 |
| 1499 |
|
0 |
0 |
0 |
0 |
| 2999 |
|
0 |
0 |
0 |
0 |
2011 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
95517 -
Aetna Health Inc ME Corp
Quarter 2 |
|
Line |
Current Year to Date |
Prior Year to Date |
Prior Year Ended December 31 |
| 33 |
Capital and surplus prior reporting year |
14,931,099 |
19,376,137 |
19,376,137 |
| 34 |
Net income or (loss) from Line 32 |
2,969,677 |
2,431,816 |
4,152,361 |
| 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 |
-357,661 |
-705,709 |
-1,224,618 |
| 39 |
Change in nonadmitted assets |
344,886 |
492,937 |
999,479 |
| 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 |
-3,600,000 |
0 |
-8,000,000 |
| 47 |
Aggregate write-ins for gains or (losses) in
surplus |
-328,602 |
71,562 |
-372,260 |
| 48 |
Net change in capital and surplus |
-971,700 |
2,290,606 |
-4,445,038 |
| 49 |
Capital and surplus end of reporting period |
13,959,399 |
21,666,743 |
14,931,099 |
|
Details of Write-Ins |
| 4701 |
Change in Additional Deferred Tax Asset Admitted
Amount |
-328,602 |
71,562 |
-372,260 |
| 4799 |
|
-328,602 |
71,562 |
-372,260 |
|
|
