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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
95517 - Aetna Hlth Inc ME Corp
Quarter 2

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) 2 7,473,067 204,223 7,677,290 6,587,712
02 Accrued medical incentive pool and bonus amounts 2 220,559 0 220,559 0
03 Unpaid claims adjustment expenses 2 136,455 0 136,455 106,669
04 Aggregate health policy reserves, including the liability of $220544 for medical loss ratio rebate per the Public Health Service Act 2 333,484 0 333,484 173,857
05 Aggregate life policy reserves 2 0 0 0 0
06 Property/casualty unearned premium reserve 2 0 0 0 0
07 Aggregate health claim reserves 2 68,961 0 68,961 49,973
08 Premiums received in advance 2 2,528,842 0 2,528,842 13,085
09 General expenses due or accrued 2 7,000 0 7,000 6,087
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 2 845,133 0 845,133 0
10.2 Net deferred tax liability 2 0 0 0 0
11 Ceded reinsurance premiums payable 2 0 0 0 0
12 Amounts withheld or retained for the account of others 2 0 0 0 0
13 Remittances and items not allocated 2 0 0 0 0
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 2 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 2 0 0 0 893,113
16 Derivatives 2 0 0 0 0
17 Payable for securities 2 0 0 0 0
18 Payable for securities lending 2 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers and $0 unauthorized reinsurers) 2 0 0 0 0
20 Reinsurance in unauthorized companies 2 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 2 0 0 0 0
22 Liability for amounts held under uninsured plans 2 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 2 307,803 0 307,803 188,064
24 Total liabilities (Lines 1 to 23) 2 11,921,304 204,223 12,125,527 8,018,560
25 Aggregate write-ins for special surplus funds 2     0 331,882
26 Common capital stock 2     1,000,000 1,000,000
27 Preferred capital stock 2     0 0
28 Gross paid in and contributed surplus 2     8,700,000 8,700,000
29 Surplus notes 2     0 0
30 Aggregate write-ins for other than special surplus funds 2     0 0
31 Unassigned funds (surplus) 2     4,563,542 1,340,048
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost) 2     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost) 2     0 0
33 Total capital and surplus 2     14,263,542 11,371,930
34 Total liabilities, capital and surplus 2     26,389,069 19,390,490
Details of Write-Ins
2301 CMS Payable 2 145,147 0 145,147 1,391
2302 CMS Coverage Gap Discount 2 130,429 0 130,429 174,079
2303 Medicare Part D Catastrophic Coverage Payable 2 21,068 0 21,068 0
2304 Other Payable 2 10,208 0 10,208 0
2305 Pharmacy Manufacturer's Discount Payable 2 951 0 951 0
2306 Medicare Part D Low Income Cost Share Payable 2 0 0 0 12,594
2399   2 307,803 0 307,803 188,064
2501 Additional Deferred Tax Asset Admitted Amount 2     0 331,882
2599   2     0 331,882
3099   2     0 0

Last Updated: November 20, 2012