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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
52618 - Anthem Hlth Plans of ME Inc
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 86,810,344 369,850 87,180,194 97,012,263
02 Accrued medical incentive pool and bonus amounts 1 0 0 0 0
03 Unpaid claims adjustment expenses 1 2,018,920 0 2,018,920 2,166,078
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 1 75,548,653 0 75,548,653 76,119,089
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 1,886,222 0 1,886,222 1,899,266
08 Premiums received in advance 1 18,196,048 0 18,196,048 18,973,909
09 General expenses due or accrued 1 9,370,086 0 9,370,086 9,406,290
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 1 5,804,470 0 5,804,470 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 1 543,229 0 543,229 438,057
13 Remittances and items not allocated 1 4,422,575 0 4,422,575 3,926,224
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 29,457,381 0 29,457,381 32,513,158
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 10,961,521 0 10,961,521 6,747,057
23 Aggregate write-ins for other liabilities (including $762571 current) 1 6,815,219 0 6,815,219 7,031,208
24 Total liabilities (Lines 1 to 23) 1 251,834,668 369,850 252,204,518 256,232,599
25 Aggregate write-ins for special surplus funds 1     0 0
26 Common capital stock 1     2,500,000 2,500,000
27 Preferred capital stock 1     0 0
28 Gross paid in and contributed surplus 1     120,652,900 120,652,900
29 Surplus notes 1     0 0
30 Aggregate write-ins for other than special surplus funds 1     0 0
31 Unassigned funds (surplus) 1     121,640,961 101,489,895
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     244,793,861 224,642,795
34 Total liabilities, capital and surplus 1     496,998,379 480,875,394
Details of Write-Ins
2301 FEP SPECIAL ADVANCE 1 4,428,350 0 4,428,350 4,428,350
2302 OTHER LIABILITIES 1 1,006,207 0 1,006,207 1,082,807
2303 ESCHEAT LIABILITY 1 1,011,770 0 1,011,770 940,233
2304 RETROACTIVITY LIABILITY 1 368,892 0 368,892 579,818
2399   1 6,815,219 0 6,815,219 7,031,208
2599   1     0 0
3099   1     0 0

Last Updated: November 20, 2012