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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
52618 - Anthem Hlth Plans of ME Inc

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 03/06/2013
Line Covered Current Year Uncovered Current Year Total Current Year Total Prior Year
01 Claims unpaid (less $2953982 reinsurance ceded) 91,396,265 393,839 91,790,104 97,012,263
02 Accrued medical incentive pool and bonus amounts 0 0 0 0
03 Unpaid claims adjustment expenses 2,262,466 0 2,262,466 2,166,078
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 85,957,352 0 85,957,352 76,119,089
05 Aggregate life policy reserves 0 0 0 0
06 Property/casualty unearned premium reserves 0 0 0 0
07 Aggregate health claim reserves 1,384,446 0 1,384,446 1,899,266
08 Premiums received in advance 16,064,595 0 16,064,595 18,973,909
09 General expenses due or accrued 8,432,132 0 8,432,132 9,406,290
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 3,045,501 0 3,045,501 0
10.2 Net deferred tax liability 0 0 0 0
11 Ceded reinsurance premiums payable 672,353 0 672,353 0
12 Amounts withheld or retained for the account of others 366,272 0 366,272 438,057
13 Remittances and items not allocated 4,538,499 0 4,538,499 3,926,224
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 40,348,820 0 40,348,820 32,513,158
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 10,103,547 0 10,103,547 6,747,057
23 Aggregate write-ins for other liabilities (including $1125335 current) 7,117,297 0 7,117,297 7,031,208
24 Total liabilities (Lines 1 to 23) 271,689,545 393,839 272,083,384 256,232,599
25 Aggregate write-ins for special surplus funds     0 0
26 Common capital stock     2,500,000 2,500,000
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     120,652,900 120,652,900
29 Surplus notes     0 0
30 Aggregate write-ins for other than special surplus funds     0 0
31 Unassigned funds (surplus)     19,636,477 101,489,895
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     142,789,377 224,642,795
34 Total liabilities, capital and surplus     414,872,761 480,875,394
Details of Write-Ins
2301 FEP SPECIAL ADVANCE 4,353,675 0 4,353,675 4,428,350
2302 ESCHEAT LIABILITY 1,099,343 0 1,099,343 940,233
2303 OTHER LIABILITIES 1,090,904 0 1,090,904 1,082,807
2304 RETROACTIVITY LIABILITY 573,375 0 573,375 579,818
2399   7,117,297 0 7,117,297 7,031,208
2599       0 0
3099       0 0

Last Updated: March 6, 2013