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2013 LIABILITIES, CAPITAL AND SURPLUS - 003
12151 - Arcadian Hlth Plan Inc

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) 24,449,269 3,494,901 27,944,170 44,080,020
02 Accrued medical incentive pool and bonus amounts 0 0 0 0
03 Unpaid claims adjustment expenses 236,831 0 236,831 291,851
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 663,168 0 663,168 389,199
05 Aggregate life policy reserves 0 0 0 0
06 Property/casualty unearned premium reserves 0 0 0 0
07 Aggregate health claim reserves 0 0 0 0
08 Premiums received in advance 69,122 0 69,122 446,047
09 General expenses due or accrued 2,617,078 0 2,617,078 17,045,924
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 4,873,640
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 3,054 0 3,054 28,520
13 Remittances and items not allocated 129,101 0 129,101 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 319,277 0 319,277 2,387,922
16 Derivatives 0 0 0 0
17 Payable for securities 0 0 0 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 1,129,982 0 1,129,982 1,719,614
23 Aggregate write-ins for other liabilities (including $135344 current) 135,344 0 135,344 1,344
24 Total liabilities (Lines 1 to 23) 29,752,226 3,494,901 33,247,127 71,264,081
25 Aggregate write-ins for special surplus funds     0 0
26 Common capital stock     600,000 600,000
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     68,696,777 68,696,777
29 Surplus notes     0 0
30 Aggregate write-ins for other-than-special surplus funds     0 0
31 Unassigned funds (surplus)     1,038,041 2,777,861
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     70,334,818 72,074,638
34 Total liabilities, capital and surplus     103,581,945 143,338,719
Details of Write-Ins
2301 MEDICARE RISK ADJUSTMENT PREMIUM PAYABLE 135,344 0 135,344 1,344
2399   135,344 0 135,344 1,344
2599       0 0
3001       0 0
3099       0 0

Last Updated: March 3, 2014