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2012 STATEMENT OF REVENUE AND EXPENSES - 004
95447 - Cigna Hlthcare of ME Inc

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 03/06/2013
Line Uncovered Current Year Total Current Year Total Prior Year
01 Member months   0 0
02 Net premium income (including $0 non-health premium income)   411 6,826
03 Change in unearned premium reserves and reserve for rate credits   0 0
04 Fee-for-service (net of $0 medical expenses)   0 0
05 Risk revenue   0 0
06 Aggregate write-ins for other health care related revenues   0 0
07 Aggregate write-ins for other non-health revenues   0 0
08 Total revenues   411 6,826
09 Hospital/medical benefits (hospital and medical) 0 0 -46,732
10 Other professional services (hospital and medical) 0 -3,806 -126
11 Outside referrals (hospital and medical) 0 0 177
12 Emergency room and out-of-area (hospital and medical) 0 0 -2,014
13 Prescription drugs (hospital and medical) 0 0 0
14 Aggregate write-ins for other hospital and medical (hospital and medical) 0 0 0
15 Incentive pool, withhold adjustments and bonus amounts (hospital and medical) 0 0 0
16 Subtotal (hospital and medical) 0 -3,806 -48,695
17 Net reinsurance recoveries (less) 0 0 0
18 Total hospital and medical (less) 0 -3,806 -48,695
19 Non-health claims (net) (less) 0 0 0
20 Claims adjustment expenses, including $0 cost containment expenses (less) 0 15 -1,596
21 General administrative expenses (less) 0 150,500 2,030
22 Increase in reserves for life and accident and health contracts (including $0 increase in reserves for life only) (less) 0 0 -60
23 Total underwriting deductions 0 146,709 -48,321
24 Net underwriting gain or (loss)   -146,298 55,147
25 Net investment income earned 0 334,468 350,093
26 Net realized capital gains or (losses) less capital gains tax of $3080 0 437,531 0
27 Net investment gains or (losses) 0 771,999 350,093
28 Net gain or (loss) from agents' or premium balances charged off [(amount recovered $0 (amount charged off $0] 0 0 0
29 Aggregate write-ins for other income or expenses 0 0 0
30 Net income or (loss), after capital gains tax and before all other federal income taxes   625,701 405,240
31 Federal and foreign income taxes incurred   -8,522 34,740
32 Net income (loss)   634,223 370,500
Details of Write-Ins
0601     0 0
0699     0 0
0799     0 0
1499   0 0 0
2999   0 0 0

 

2012 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
95447 - Cigna Hlthcare of ME Inc

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 03/06/2013
Line Current Year Prior Year
33 Capital and surplus prior reporting year 9,732,210 9,365,901
34 Net income or (loss) from Line 32 634,223 370,500
35 Change in valuation basis of aggregate policy and claim reserves 0 0
36 Change in net unrealized capital gains (losses) less capital gains tax of $0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 0 0
38 Change in net deferred income tax -129,441 -7,769
39 Change in nonadmitted assets 120 3,578
40 Change in unauthorized and certified reinsurance 0 0
41 Change in treasury stock 0 0
42 Change in surplus notes 0 0
43 Cumulative effect of changes in accounting principles 0 0
44.1 Paid in (capital changes) 0 0
44.2 Transferred from surplus (stock dividend) (capital changes) 0 0
44.3 Transferred to surplus (capital changes) 0 0
45.1 Paid in (surplus adjustments) 0 0
45.2 Transferred to capital (stock dividend) (surplus adjustments) 0 0
45.3 Transferred from capital (surplus adjustments) 0 0
46 Dividends to stockholders -5,000,000 0
47 Aggregate write-ins for gains or (losses) in surplus 0 0
48 Net change in capital and surplus -4,495,098 366,309
49 Capital and surplus end of reporting year 5,237,112 9,732,210
Details of Write-Ins
4799   0 0

 

Last Updated: March 6, 2013