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2012 EXHIBIT OF PREMIUMS, ENROLLMENT AND UTILIZATION - 029
12545 - Martins Point Generations LLC
for Maine

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 03/06/2013
Line State Code Total Individual Comprehensive Group Comprehensive Medicare Supplement Vision Only Dental Only Federal Employees Health Benefit Plan Title XVIII Medicare Title XIX Medicaid Other
01 Prior Year (total member at end of) ME 12,836 0 0 0 0 0 0 12,836 0 0
02 First Quarter (total members at end of) ME 15,560 0 0 0 0 0 0 15,560 0 0
03 Second Quarter (total members at end of) ME 16,517 0 0 0 0 0 0 16,517 0 0
04 Third Quarter (total members at end of) ME 17,433 0 0 0 0 0 0 17,433 0 0
05 Current Year (total members at end of) ME 18,394 0 0 0 0 0 0 18,394 0 0
06 Current Year Member Months ME 199,950 0 0 0 0 0 0 199,950 0 0
07 Physician (total member ambulatory encounters for year) ME 242,676 0 0 0 0 0 0 242,676 0 0
08 Non-physician (total member ambulatory encounters for year) ME 277,474 0 0 0 0 0 0 277,474 0 0
09 Total (total member ambulatory encounters for year) ME 520,150 0 0 0 0 0 0 520,150 0 0
10 Hospital patient days incurred ME 12,029 0 0 0 0 0 0 12,029 0 0
11 Number of inpatient admissions ME 2,684 0 0 0 0 0 0 2,684 0 0
12 Health premiums written (b) ME 132,098,338 0 0 0 0 0 0 132,098,338 0 0
13 Life premiums direct ME 0 0 0 0 0 0 0 0 0 0
14 Property/Casualty premiums written ME 0 0 0 0 0 0 0 0 0 0
15 Health premiums earned ME 132,098,338 0 0 0 0 0 0 132,098,338 0 0
16 Property/Casualty premiums earned ME 0 0 0 0 0 0 0 0 0 0
17 Amount paid for provision of health care services ME 117,502,670 0 0 0 0 0 0 117,502,670 0 0
18 Amount incurred for provision of health care services ME 122,392,045 0 0 0 0 0 0 122,392,045 0 0
FootNotes
0000001 (a) For health business number of persons insured under PPO managed care products 1692 and number of persons insured under indemnity only products 0.
0000002 (b) For health premiums written: amount of Medicare Title XVIII exempt from state taxes or fees $132098338 ~

Last Updated: March 6, 2013