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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
95517 - Aetna Hlth Inc ME Corp
Quarter 1

OLTPPROD Copyright 2012 National Association of Insurance Commissioners. All rights reserved. 11/20/2012
Line Quarter Number Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 1 8,529,917 213,540 8,743,457 6,587,712
02 Accrued medical incentive pool and bonus amounts 1 0 0 0 0
03 Unpaid claims adjustment expenses 1 141,406 0 141,406 106,669
04 Aggregate health policy reserves, including the liability of $625 for medical loss ratio rebate per the Public Health Service Act 1 97,990 0 97,990 173,857
05 Aggregate life policy reserves 1 0 0 0 0
06 Property/casualty unearned premium reserve 1 0 0 0 0
07 Aggregate health claim reserves 1 73,289 0 73,289 49,973
08 Premiums received in advance 1 2,385,564 0 2,385,564 13,085
09 General expenses due or accrued 1 0 0 0 6,087
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 1 0 0 0 0
10.2 Net deferred tax liability 1 0 0 0 0
11 Ceded reinsurance premiums payable 1 0 0 0 0
12 Amounts withheld or retained for the account of others 1 0 0 0 0
13 Remittances and items not allocated 1 0 0 0 0
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 1 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 1 1,000 0 1,000 893,113
16 Derivatives 1 0 0 0 0
17 Payable for securities 1 0 0 0 0
18 Payable for securities lending 1 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers and $0 unauthorized reinsurers) 1 0 0 0 0
20 Reinsurance in unauthorized companies 1 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 1 0 0 0 0
22 Liability for amounts held under uninsured plans 1 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 1 302,901 0 302,901 188,064
24 Total liabilities (Lines 1 to 23) 1 11,532,067 213,540 11,745,607 8,018,560
25 Aggregate write-ins for special surplus funds 1     0 331,882
26 Common capital stock 1     1,000,000 1,000,000
27 Preferred capital stock 1     0 0
28 Gross paid in and contributed surplus 1     8,700,000 8,700,000
29 Surplus notes 1     0 0
30 Aggregate write-ins for other than special surplus funds 1     0 0
31 Unassigned funds (surplus) 1     2,293,895 1,340,048
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost) 1     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost) 1     0 0
33 Total capital and surplus 1     11,993,895 11,371,930
34 Total liabilities, capital and surplus 1     23,739,502 19,390,490
Details of Write-Ins
2301 CMS Payable 1 141,852 0 141,852 1,391
2302 CMS Coverage Gap 1 117,296 0 117,296 174,079
2303 Medicare Part D Catastrophic Coverage Payable 1 43,071 0 43,071 0
2304 Pharmacy Manufacturer's Discount 1 608 0 608 0
2305 Other Payable 1 74 0 74 0
2306 Medicare Part D Low Income Cost Share Payable 1 0 0 0 12,594
2399   1 302,901 0 302,901 188,064
2501 Additional Deferred Tax Asset Admitted Amount 1     0 331,882
2599   1     0 331,882
3099   1     0 0

Last Updated: November 20, 2012