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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
95517 - Aetna Hlth Inc ME Corp

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 03/05/2013
Line Covered Current Year Uncovered Current Year Total Current Year Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 7,167,314 260,371 7,427,685 6,587,712
02 Accrued medical incentive pool and bonus amounts 231,372 0 231,372 0
03 Unpaid claims adjustment expenses 147,635 0 147,635 106,669
04 Aggregate health policy reserves, including the liability of $111148 for medical loss ratio rebate per the Public Health Service Act 213,335 0 213,335 173,857
05 Aggregate life policy reserves 0 0 0 0
06 Property/casualty unearned premium reserves 0 0 0 0
07 Aggregate health claim reserves 69,354 0 69,354 49,973
08 Premiums received in advance 6,914 0 6,914 13,085
09 General expenses due or accrued 14,201 0 14,201 6,087
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 0
10.2 Net deferred tax liability 0 0 0 0
11 Ceded reinsurance premiums payable 0 0 0 0
12 Amounts withheld or retained for the account of others 0 0 0 0
13 Remittances and items not allocated 0 0 0 0
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 4,556,051 0 4,556,051 893,113
16 Derivatives 0 0 0 0
17 Payable for securities 0 0 0 0
18 Payable for securities lending 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers, $0 unauthorized reinsurers and ($0 certified reinsurers) 0 0 0 0
20 Reinsurance in unauthorized and certified ($0) companies 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 0 0 0 0
22 Liability for amounts held under uninsured plans 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 111,882 0 111,882 188,064
24 Total liabilities (Lines 1 to 23) 12,518,058 260,371 12,778,429 8,018,560
25 Aggregate write-ins for special surplus funds     0 331,882
26 Common capital stock     1,000,000 1,000,000
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     8,700,000 8,700,000
29 Surplus notes     0 0
30 Aggregate write-ins for other than special surplus funds     0 0
31 Unassigned funds (surplus)     5,118,026 1,340,048
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost)     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost)     0 0
33 Total capital and surplus     14,818,026 11,371,930
34 Total liabilities, capital and surplus     27,596,455 19,390,490
Details of Write-Ins
2301 CMS Coverage Gap 104,569 0 104,569 174,079
2302 Other Payable 6,848 0 6,848 0
2303 Pharmacy Manufacturer's Discount Payable 465 0 465 0
2304 Medicare Part D Low Income Cost Share Payable 0 0 0 12,594
2305 CMS Payable 0 0 0 1,391
2399   111,882 0 111,882 188,064
2501 Additional Deferred Tax Asset Admitted Amount     0 331,882
2599       0 331,882
3099       0 0

Last Updated: March 6, 2013