2012 STATEMENT OF REVENUE AND EXPENSES - 004
12545 - Martins Point Generations LLC
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 |
|
45,960 |
33,502 |
142,392 |
| 02 |
Net premium income (including $0 non-health premium income) |
1 |
|
30,288,267 |
19,077,160 |
86,989,481 |
| 03 |
Change in unearned premium reserves and reserve for rate credits |
1 |
|
0 |
0 |
0 |
| 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 |
|
30,288,267 |
19,077,160 |
86,989,481 |
| 09 |
Hospital/medical benefits (hospital and medical) |
1 |
0 |
24,182,935 |
15,201,161 |
69,684,782 |
| 10 |
Other professional services (hospital and medical) |
1 |
0 |
0 |
0 |
0 |
| 11 |
Outside referrals (hospital and medical) |
1 |
0 |
0 |
0 |
0 |
| 12 |
Emergency room and out-of-area (hospital and medical) |
1 |
0 |
0 |
0 |
0 |
| 13 |
Prescription drugs (hospital and medical) |
1 |
0 |
4,742,182 |
3,481,425 |
13,528,771 |
| 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 |
145,311 |
254,604 |
189,201 |
| 16 |
Subtotal (hospital and medical) |
1 |
0 |
29,070,428 |
18,937,190 |
83,402,754 |
| 17 |
Net reinsurance recoveries (less) |
1 |
0 |
0 |
560 |
3,463 |
| 18 |
Total hospital and medical (less) |
1 |
0 |
29,070,428 |
18,936,630 |
83,399,291 |
| 19 |
Non-health claims (net) (less) |
1 |
0 |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses, including $369559 cost containment expenses (less) |
1 |
0 |
625,368 |
447,526 |
2,221,664 |
| 21 |
General administrative expenses (less) |
1 |
0 |
3,566,912 |
3,797,637 |
13,221,643 |
| 22 |
Increase in reserves for life and accident and health contracts (including $0 increase in reserves for life only) (less) |
1 |
0 |
0 |
0 |
0 |
| 23 |
Total underwriting deductions |
1 |
0 |
33,262,708 |
23,181,793 |
98,842,598 |
| 24 |
Net underwriting gain or (loss) |
1 |
|
-2,974,441 |
-4,104,633 |
-11,853,117 |
| 25 |
Net investment income earned |
1 |
0 |
5,178 |
10,809 |
35,566 |
| 26 |
Net realized capital gains (losses) less capital gains tax of $0 |
1 |
0 |
0 |
0 |
0 |
| 27 |
Net investment gains or (losses) |
1 |
0 |
5,178 |
10,809 |
35,566 |
| 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 |
|
-2,969,263 |
-4,093,824 |
-11,817,551 |
| 31 |
Federal and foreign income taxes incurred |
1 |
|
0 |
0 |
0 |
| 32 |
Net income (loss) |
1 |
|
-2,969,263 |
-4,093,824 |
-11,817,551 |
|
Details of Write-Ins |
| 0601 |
|
1 |
|
0 |
0 |
0 |
| 0602 |
|
1 |
|
0 |
0 |
0 |
| 0603 |
|
1 |
|
0 |
0 |
0 |
| 0699 |
|
1 |
|
0 |
0 |
0 |
| 0701 |
|
1 |
|
0 |
0 |
0 |
| 0702 |
|
1 |
|
0 |
0 |
0 |
| 0703 |
|
1 |
|
0 |
0 |
0 |
| 0799 |
|
1 |
|
0 |
0 |
0 |
| 1401 |
|
1 |
0 |
0 |
0 |
0 |
| 1402 |
|
1 |
0 |
0 |
0 |
0 |
| 1403 |
|
1 |
0 |
0 |
0 |
0 |
| 1499 |
|
1 |
0 |
0 |
0 |
0 |
| 2901 |
|
1 |
0 |
0 |
0 |
0 |
| 2902 |
|
1 |
0 |
0 |
0 |
0 |
| 2903 |
|
1 |
0 |
0 |
0 |
0 |
| 2999 |
|
1 |
0 |
0 |
0 |
0 |
|
2012 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
12545 - Martins Point Generations LLC
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 |
9,410,776 |
5,257,792 |
5,257,792 |
| 34 |
Net income or (loss) from Line 32 |
1 |
-2,969,263 |
-4,093,824 |
-11,817,551 |
| 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 |
0 |
0 |
0 |
| 39 |
Change in nonadmitted assets |
1 |
51,787 |
-58,584 |
-29,465 |
| 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 |
1,200,000 |
4,770,000 |
16,000,000 |
| 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 |
0 |
| 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 |
0 |
| 47 |
Aggregate write-ins for gains or (losses) in surplus |
1 |
0 |
-1 |
0 |
| 48 |
Net change in capital and surplus |
1 |
-1,717,476 |
617,591 |
4,152,984 |
| 49 |
Capital and surplus end of reporting period |
1 |
7,693,300 |
5,875,383 |
9,410,776 |
|
Details of Write-Ins |
| 4701 |
|
1 |
0 |
-1 |
0 |
| 4702 |
|
1 |
0 |
0 |
0 |
| 4703 |
|
1 |
0 |
0 |
0 |
| 4799 |
|
1 |
0 |
-1 |
0 |
|
Last Updated:
November 20, 2012
|
