|
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 |
|
377,829 |
355,722 |
480,377 |
| 02 |
Net premium income (including $0 non-health premium
income) |
|
308,547,919 |
282,254,754 |
379,650,685 |
| 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 |
|
308,547,919 |
282,254,754 |
379,650,685 |
| 09 |
Hospital/medical benefits (hospital and medical) |
0 |
140,118,070 |
125,405,905 |
171,597,719 |
| 10 |
Other professional services (hospital and
medical) |
0 |
50,434,974 |
44,021,876 |
61,100,675 |
| 11 |
Outside referrals (hospital and medical) |
31,518,691 |
31,518,691 |
18,868,118 |
27,414,513 |
| 12 |
Emergency room and out-of-area (hospital and
medical) |
3,274,169 |
11,292,950 |
9,514,168 |
13,077,550 |
| 13 |
Prescription drugs (hospital and medical) |
0 |
26,574,162 |
28,896,595 |
38,677,496 |
| 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 |
434,159 |
566,615 |
454,414 |
| 16 |
Subtotal (hospital and medical) |
34,792,860 |
260,373,006 |
227,273,277 |
312,322,367 |
| 17 |
Net reinsurance recoveries (less) |
0 |
940,233 |
363,959 |
1,019,566 |
| 18 |
Total hospital and medical (less) |
34,792,860 |
259,432,773 |
226,909,318 |
311,302,801 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses, including $0 cost
containment expenses (less) |
0 |
12,016,307 |
10,291,371 |
14,121,037 |
| 21 |
General administrative expenses (less) |
0 |
41,314,483 |
39,797,679 |
52,450,845 |
| 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 |
34,792,860 |
312,763,563 |
276,998,368 |
377,874,683 |
| 24 |
Net underwriting gain or (loss) |
|
-4,215,644 |
5,256,386 |
1,776,002 |
| 25 |
Net investment income earned |
0 |
3,946,554 |
1,960,318 |
2,302,488 |
| 26 |
Net realized capital gains (losses) less capital
gains tax of $0 |
0 |
-124 |
7,917 |
8,573 |
| 27 |
Net investment gains or (losses) |
0 |
3,946,430 |
1,968,235 |
2,311,061 |
| 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 |
|
-269,214 |
7,224,621 |
4,087,063 |
| 31 |
Federal and foreign income taxes incurred |
|
0 |
2,285,066 |
461,009 |
| 32 |
Net income (loss) |
|
-269,214 |
4,939,555 |
3,626,054 |
|
Details of Write-Ins |
| 0699 |
|
|
0 |
0 |
0 |
| 0799 |
|
|
0 |
0 |
0 |
| 1401 |
VISION |
0 |
0 |
0 |
0 |
| 1499 |
|
0 |
0 |
0 |
0 |
| 2999 |
|
0 |
0 |
0 |
0 |
2011 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
12151 -
Arcadian Health Plan Inc
Quarter 3 |
|
Line |
Current Year to Date |
Prior Year to Date |
Prior Year Ended December 31 |
| 33 |
Capital and surplus prior reporting year |
44,732,871 |
45,183,078 |
45,183,078 |
| 34 |
Net income or (loss) from Line 32 |
-269,214 |
4,939,555 |
3,626,054 |
| 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 |
-3,784,977 |
2,510,404 |
2,306,238 |
| 37 |
Change in net unrealized foreign exchange capital
gain or (loss) |
0 |
0 |
0 |
| 38 |
Change in net deferred income tax |
0 |
65,715 |
14,761 |
| 39 |
Change in nonadmitted assets |
-600,590 |
755,839 |
-1,804,602 |
| 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 |
-4,470,000 |
| 47 |
Aggregate write-ins for gains or (losses) in
surplus |
85,657 |
-46,710 |
-122,658 |
| 48 |
Net change in capital and surplus |
-4,569,124 |
8,224,803 |
-450,207 |
| 49 |
Capital and surplus end of reporting period |
40,163,747 |
53,407,881 |
44,732,871 |
|
Details of Write-Ins |
| 4701 |
Audit Adjustments |
85,657 |
-46,710 |
-75,948 |
| 4702 |
Audit Adjustment - Paid in Capital Adjustment
recorded in unassigned funds in PY |
0 |
0 |
-46,710 |
| 4799 |
|
85,657 |
-46,710 |
-122,658 |
|
|
