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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
12151 - Arcadian Hlth Plan Inc
Quarter 2

OLTPPROD Copyright 2012 National Association of Insurance Commissioners. All rights reserved. 11/21/2012
Line Quarter Number Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 2 42,576,950 1,355,498 43,932,448 40,984,393
02 Accrued medical incentive pool and bonus amounts 2 0 0 0 400,675
03 Unpaid claims adjustment expenses 2 254,547 0 254,547 1,081,716
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 2 1,504,245 0 1,504,245 1,389,674
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 0 0 0 0
08 Premiums received in advance 2 33,141,891 0 33,141,891 0
09 General expenses due or accrued 2 5,848,899 0 5,848,899 8,348,324
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 2 0 0 0 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 43,349 0 43,349 183,576
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 23,272,096 0 23,272,096 0
16 Derivatives 2 0 0 0 0
17 Payable for securities 2 8,290 0 8,290 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 5,863,516 0 5,863,516 2,603,767
23 Aggregate write-ins for other liabilities (including $0 current) 2 0 0 0 0
24 Total liabilities (Lines 1 to 23) 2 112,513,783 1,355,498 113,869,281 54,992,125
25 Aggregate write-ins for special surplus funds 2     0 0
26 Common capital stock 2     600,000 600,000
27 Preferred capital stock 2     0 0
28 Gross paid in and contributed surplus 2     48,696,777 34,696,777
29 Surplus notes 2     0 0
30 Aggregate write-ins for other than special surplus funds 2     0 0
31 Unassigned funds (surplus) 2     -6,884,709 3,160,876
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     42,412,068 38,457,653
34 Total liabilities, capital and surplus 2     156,281,349 93,449,778
Details of Write-Ins
2301   2 0 0 0 0
2302   2 0 0 0 0
2303   2 0 0 0 0
2399   2 0 0 0 0
2501   2     0 0
2502   2     0 0
2503   2     0 0
2599   2     0 0
3001   2     0 0
3002   2     0 0
3003   2     0 0
3099   2     0 0

Last Updated: November 21, 2012