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HEALTH ANNUAL STATEMENT

For the Year Ended December 31, 2012
of the Condition and Affairs of the

Arcadian Health Plan, Inc.

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

NAIC Company Code..... 12151

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

Organized under the Laws of Washington

State of Domicile or Port of Entry Washington

Country of Domicile United States of America

Licensed as Business Type.....Other

Is HMO Federally Qualified? Yes [ X ] No [ ]

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

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

Statutory Home Office 118920 Bothell Way NE, #100.. Bothell ..... WA ..... 98011
(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 P.O. Box 740036.. Louisvill..... KY ..... 40201-7436
(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 Website Address www.humana.com

Statutory Statement Contact Jimmy Blandford 502-580-4381
(Name) (Area Code) (Telephone Number)
DOINQUIRIES@humana.com 502-580-2099
(E-Mail Address) (Fax Number)

OFFICERS
Bruce Dale Croussard #, CEO/President
James Harry Bloem #, Sr. VP, CFO & Treasurer
Joan Olliges Lenahan #, VP & Corporate Secretary
Jonathan Albert Canine #, Appointed Actuary

OTHER OFFICERS
George Grant Bauernfeind #, Vice President
John Gregory Catron #, VP & Chief compliance Officer
Roy Goldman Ph.D. #, VP & Chief Actuary
Brian Phillip LeClaire #, Sr. VP & Chief Service & Info Officer
Bruce Devereau Perkins #, Pres., Health & Well-Being Serv Seg
Oraida Maria Roman #, Reg Pres Sr Prod/Intermountain Reg
Joseph Christopher Ventura #, Assistant Secretary
Ralph Martin Wilson #, Vice President
Elizabeth Diane Bierbower #, Pres., Employer Group Segment
Michael Paul Franks #, Reg. Pres.-Sr. Prod/West Coast Reg.
Charles Frederic Lambert III #, Vice President
Thomas Joseph Liston #, President, Retail Segment
Richard Donald Remmers #, Seg. VP, Employer Group Sales
Pattie Dale Tye #, President, Large Group
Timothy Alan Wheatley #, VP-Senior Products

DIRECTORS OR TRUSTEES
James Harry Bloem #
Bruce Dale Broussard #
James Elmer Murray #

 

State of........ Kentucky
County of..... Jefferson

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.


______________________________________
Bruce Dale Broussard
CEO/President

______________________________________
Joan Olliges Lenahan
VP & Corporate Secretary

______________________________________
James Harry Bloem
Sr. VP, CFO & Treasurer

Subscribed and sworn to before me this

....21st..........day of .......February, 2013.....................................................

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

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: March 6, 2013