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HEALTH QUARTERLY STATEMENT

As of September 30, 2011
of the Condition and Affairs of the

Arcadian Health Plan, Inc.

NAIC Group Code..... 3681 3681
(Current) (Prior)

NAIC Company Code..... 12151

Employer's ID Number..... 20-1001348

Organized under the Laws of California

State of Domicile or Port of Entry California

Country of Domicile United States

Licensed as business type: Life, Accident and Health [ ] Property/Casualty [ ] Hospital, Medical and Dental Service or Indemnity [ ]
Dental Service Corporation [ ] Vision Service Corporation [ ] Health Maintenance Organization [ X ]
Other [ ] Is HMO Federally Qualified? Yes [X] No [ ]

Incorporated/Organized..... 04/06/2004

Commenced Business..... 01/01/2005

Statutory Home Office 1330 N. Washington St., Suite 3500... Spokane ..... WA ..... 92201
(Street and Number) (City or Town, State and Zip Code)

Main Administrative Office 500 12th Street, Ste 350... Oakland .... CA ... 94607 510-832-0311
(Street and Number) (City or Town, State and Zip Code) (Area Code) (Telephone Number)

Mail Address 500 12th Street, Ste 350... Oakland .... CA ... 94607
(Street and Number or P.O. Box) (City or Town, State and Zip Code)

Primary Location of Books and Records 500 12th Street, Ste 350... Oakland .... CA ... 94607 510-832-0311
(Street and Number) (City or Town, State and Zip Code) (Area Code) (Telephone Number)

Internet Web Site Address www.arcadianhealth.com

Statutory Statement Contact Stacy Elise Parsons 510-817-1815
(Name) (Area Code) (Telephone Number)
sparsons@arcadianhealth.com 510-817-1895
(E-mail Address) (FAX Number)

OFFICERS
Robert Lawrence Fahlman, CEO and President
Kenneth Benjamin Zimmerman, Treasurer
James Francis Novello, Secretary


OTHER OFFICERS

DIRECTORS OR TRUSTEES
Robert Lawrence Fahlman
Chase Spencer Milbrandt
Jeffrey Craig McManus

State of........ California
County of..... Alameda

The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement.


______________________________________
Robert Lawrence Fahlman
CEO and President

______________________________________
James Francis Novello
Secretary

______________________________________
Kenneth Benjamin Zimmerman
Treasurer

Subscribed and sworn to before me this

..............day of ............................................................

.....................................................................................

a. Is this an original filing? Yes [ X ] No [ ]
b. If no,
1. State the amendment number.....
2. Date filed.................................
3. Number of pages attached.......


 

Last Updated: September 27, 2010