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2012 LIABILITIES, CAPITAL AND SURPLUS - 003
52618 - Anthem Hlth Plans of ME Inc
Quarter 3

OLTPPROD Copyright 2012 National Association of Insurance Commissioners. All rights reserved. 11/19/2012
Line Quarter Number Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $1970706 reinsurance ceded) 3 86,275,611 351,531 86,627,142 97,012,263
02 Accrued medical incentive pool and bonus amounts 3 0 0 0 0
03 Unpaid claims adjustment expenses 3 2,074,274 0 2,074,274 2,166,078
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 3 67,252,452 0 67,252,452 76,119,089
05 Aggregate life policy reserves 3 0 0 0 0
06 Property/casualty unearned premium reserve 3 0 0 0 0
07 Aggregate health claim reserves 3 1,836,281 0 1,836,281 1,899,266
08 Premiums received in advance 3 12,074,978 0 12,074,978 18,973,909
09 General expenses due or accrued 3 8,050,288 0 8,050,288 9,406,290
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 3 1,553,860 0 1,553,860 0
10.2 Net deferred tax liability 3 0 0 0 0
11 Ceded reinsurance premiums payable 3 1,966,009 0 1,966,009 0
12 Amounts withheld or retained for the account of others 3 448,772 0 448,772 438,057
13 Remittances and items not allocated 3 5,403,708 0 5,403,708 3,926,224
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 3 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 3 13,876,926 0 13,876,926 32,513,158
16 Derivatives 3 0 0 0 0
17 Payable for securities 3 0 0 0 0
18 Payable for securities lending 3 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers and $0 unauthorized reinsurers) 3 0 0 0 0
20 Reinsurance in unauthorized companies 3 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 3 0 0 0 0
22 Liability for amounts held under uninsured plans 3 10,708,456 0 10,708,456 6,747,057
23 Aggregate write-ins for other liabilities (including $1245703 current) 3 6,299,508 0 6,299,508 7,031,208
24 Total liabilities (Lines 1 to 23) 3 217,821,123 351,531 218,172,654 256,232,599
25 Aggregate write-ins for special surplus funds 3     0 0
26 Common capital stock 3     2,500,000 2,500,000
27 Preferred capital stock 3     0 0
28 Gross paid in and contributed surplus 3     120,652,900 120,652,900
29 Surplus notes 3     0 0
30 Aggregate write-ins for other than special surplus funds 3     0 0
31 Unassigned funds (surplus) 3     134,499,143 101,489,895
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost) 3     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost) 3     0 0
33 Total capital and surplus 3     257,652,043 224,642,795
34 Total liabilities, capital and surplus 3     475,824,697 480,875,394
Details of Write-Ins
2301 FEP SPECIAL ADVANCE 3 3,616,105 0 3,616,105 4,428,350
2302 OTHER LIABILITIES 3 1,015,727 0 1,015,727 1,082,807
2303 ESCHEAT LIABILITY 3 1,156,204 0 1,156,204 940,233
2304 RETROACTIVITY LIABILITY 3 511,472 0 511,472 579,818
2399   3 6,299,508 0 6,299,508 7,031,208
2599   3     0 0
3099   3     0 0

Last Updated: November 19, 2012