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2012 STATEMENT OF REVENUE AND EXPENSES - 004
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 Uncovered Current Year to Date Total Current Year to Date Total Prior Year to Date Total Prior Year Ended December 31
01 Member months 1   44,974 35,341 143,015
02 Net premium income (including $0 non-health premium income) 1   22,410,802 18,361,797 72,733,787
03 Change in unearned premium reserves and reserve for rate credits 1   -1,916 5,239 11,893
04 Fee-for-service (net of $0 medical expenses) 1   0 0 0
05 Risk revenue 1   0 0 0
06 Aggregate write-ins for other health care related revenues 1   0 0 0
07 Aggregate write-ins for other non-health revenues 1   0 0 0
08 Total revenues 1   22,408,886 18,367,036 72,745,680
09 Hospital/medical benefits (hospital and medical) 1 238,632 14,415,691 12,793,354 42,530,701
10 Other professional services (hospital and medical) 1 0 0 0 0
11 Outside referrals (hospital and medical) 1 195,710 195,710 186,003 590,825
12 Emergency room and out-of-area (hospital and medical) 1 28,500 949,984 877,010 2,922,237
13 Prescription drugs (hospital and medical) 1 32,637 3,606,326 1,730,604 11,191,628
14 Aggregate write-ins for other hospital and medical (hospital and medical) 1 0 0 0 0
15 Incentive pool, withhold adjustments and bonus amounts (hospital and medical) 1 0 0 0 0
16 Subtotal (hospital and medical) 1 495,479 19,167,711 15,586,971 57,235,391
17 Net reinsurance recoveries (less) 1 0 0 0 0
18 Total hospital and medical (less) 1 495,479 19,167,711 15,586,971 57,235,391
19 Non-health claims (net) (less) 1 0 0 0 0
20 Claims adjustment expenses, including $350785 cost containment expenses (less) 1 0 520,600 366,259 1,561,096
21 General administrative expenses (less) 1 0 2,117,118 1,769,008 7,197,621
22 Increase in reserves for life and accident and health contracts (including $0 increase in reserves for life only) (less) 1 0 -77,783 119,612 122,888
23 Total underwriting deductions 1 495,479 21,727,646 17,841,850 66,116,996
24 Net underwriting gain or (loss) 1   681,240 525,186 6,628,684
25 Net investment income earned 1 0 173,051 206,392 756,252
26 Net realized capital gains (losses) less capital gains tax of $6725 1 0 13,105 -23,708 -6,813
27 Net investment gains or (losses) 1 0 186,156 182,684 749,439
28 Net gain or (loss) from agents' or premium balances charged off [(amount recovered $0 (amount charged off $0] 1 0 0 0 0
29 Aggregate write-ins for other income or expenses 1 0 0 0 0
30 Net income or (loss) after capital gains tax and before all other federal income taxes 1   867,396 707,870 7,378,123
31 Federal and foreign income taxes incurred 1   259,507 11,207 1,744,167
32 Net income (loss) 1   607,889 696,663 5,633,956
Details of Write-Ins
0699   1   0 0 0
0799   1   0 0 0
1499   1 0 0 0 0
2999   1 0 0 0 0

 

2012 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
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 Current Year to Date Prior Year to Date Prior Year Ended December 31
33 Capital and surplus prior reporting year 1 11,371,930 14,931,099 14,931,099
34 Net income or (loss) from Line 32 1 607,889 696,663 5,633,956
35 Change in valuation basis of aggregate policy and claim reserves 1 0 0 0
36 Change in net unrealized capital gains (losses) less capital gains tax of $0 1 0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 1 0 0 0
38 Change in net deferred income tax 1 43,449 -188,654 -711,901
39 Change in nonadmitted assets 1 -29,373 119,771 747,022
40 Change in unauthorized reinsurance 1 0 0 0
41 Change in treasury stock 1 0 0 0
42 Change in surplus notes 1 0 0 0
43 Cumulative effect of changes in accounting principles 1 0 0 0
44.1 Paid in (capital changes) 1 0 0 0
44.2 Transferred from surplus (stock dividend) (capital changes) 1 0 0 0
44.3 Transferred to surplus (capital changes) 1 0 0 0
45.1 Paid in (surplus adjustments) 1 0 0 -1,000,000
45.2 Transferred to capital (stock dividend) (surplus adjustments) 1 0 0 0
45.3 Transferred from capital (surplus adjustments) 1 0 0 0
46 Dividends to stockholders 1 0 0 -7,600,000
47 Aggregate write-ins for gains or (losses) in surplus 1 0 -184,770 -628,246
48 Net change in capital and surplus 1 621,965 443,010 -3,559,169
49 Capital and surplus end of reporting period 1 11,993,895 15,374,109 11,371,930
Details of Write-Ins
4701 Change in Additional Deferred Tax Asset Admitted Amount 1 0 -184,770 -628,246
4799   1 0 -184,770 -628,246

 

Last Updated: November 20, 2012