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2013 LIABILITIES, CAPITAL AND SURPLUS - 003
95517 - Aetna Hlth Inc ME Corp

OLTPPROD Copyright 2014 National Association of Insurance Commissioners. All rights reserved. 03/03/2014
Line
Covered Current Year
Uncovered Current Year
Total Current Year
Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 8,807,600 302,656 9,110,256 7,427,685
02 Accrued medical incentive pool and bonus amounts 231,372 0 231,372 231,372
03 Unpaid claims adjustment expenses 169,805 0 169,805 147,635
04 Aggregate health policy reserves, including the liability of $405 for medical loss ratio rebate per the Public Health Service Act 2,150,943 0 2,150,943 213,335
05 Aggregate life policy reserves 0 0 0 0
06 Property/casualty unearned premium reserves 0 0 0 0
07 Aggregate health claim reserves 54,939 0 54,939 69,354
08 Premiums received in advance 18,114 0 18,114 6,914
09 General expenses due or accrued 31,666 0 31,666 14,201
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 232,853 0 232,853 0
10.2 Net deferred tax liability 0 0 0 0
11 Ceded reinsurance premiums payable 0 0 0 0
12 Amounts withheld or retained for the account of others 0 0 0 0
13 Remittances and items not allocated 0 0 0 0
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 4,151,258 0 4,151,258 4,556,051
16 Derivatives 0 0 0 0
17 Payable for securities 3,935,836 0 3,935,836 0
18 Payable for securities lending 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers, $0 unauthorized reinsurers and ($0 certified reinsurers) 0 0 0 0
20 Reinsurance in unauthorized and certified ($0) companies 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 0 0 0 0
22 Liability for amounts held under uninsured plans 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 157,859 0 157,859 111,882
24 Total liabilities (Lines 1 to 23) 19,942,245 302,656 20,244,901 12,778,429
25 Aggregate write-ins for special surplus funds     0 0
26 Common capital stock     1,000,000 1,000,000
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     8,700,000 8,700,000
29 Surplus notes     0 0
30 Aggregate write-ins for other-than-special surplus funds     0 0
31 Unassigned funds (surplus)     4,208,387 5,118,026
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost)     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost)     0 0
33 Total capital and surplus     13,908,387 14,818,026
34 Total liabilities, capital and surplus     34,153,288 27,596,455
Details of Write-Ins
2301 CMS Coverage Gap Discount 51,579 0 51,579 104,569
2302 Medicare Part D Low Income Cost Share Payable 33,235 0 33,235 0
2303 Payables Associated With Claims Overpayment Recovery 25,000 0 25,000 0
2304 CMS Payable 22,402 0 22,402 0
2305 Other Payable 13,019 0 13,019 6,848
2306 Deferred Gain 12,000 0 12,000 0
2307 Pharmacy Manufacturer's Discount Payable 624 0 624 465
2399   157,859 0 157,859 111,882
2599       0 0
3099       0 0

Last Updated: March 3, 2014