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2013 SCHEDULE T - 038
12151 - Arcadian Hlth Plan Inc

OLTPPROD Copyright 2014 National Association of Insurance Commissioners. All rights reserved. 03/03/2014
Line
Active Status
Accident & Health Premiums
Medicare Title XVIII
Medicaid Title XIX
Federal Employees Health Benefits Plan Premiums
Life & Annuity Premiums & Other Considerations
Property/Casualty Premiums
Total Columns 2 through 7
Deposit-Type Contracts
Branch Operations Indicator
01 Alabama AL N 0 0 0 0 0 0 0 0  
02 Alaska AK N 0 0 0 0 0 0 0 0  
03 Arizona AZ L 0 -514,755 0 0 0 0 -514,755 0  
04 Arkansas AR N 0 0 0 0 0 0 0 0  
05 California CA L 0 15,968,025 0 0 0 0 15,968,025 0  
06 Colorado CO N 0 0 0 0 0 0 0 0  
07 Connecticut CT N 0 0 0 0 0 0 0 0  
08 Delaware DE N 0 0 0 0 0 0 0 0  
09 Dist. Columbia DC N 0 0 0 0 0 0 0 0  
10 Florida FL N 0 0 0 0 0 0 0 0  
11 Georgia GA N 0 0 0 0 0 0 0 0  
12 Hawaii HI N 0 0 0 0 0 0 0 0  
13 Idaho ID N 0 0 0 0 0 0 0 0  
14 Illinois IL N 0 0 0 0 0 0 0 0  
15 Indiana IN L 0 0 0 0 0 0 0 0  
16 Iowa IA N 0 0 0 0 0 0 0 0  
17 Kansas KS N 0 0 0 0 0 0 0 0  
18 Kentucky KY L 0 0 0 0 0 0 0 0  
19 Louisiana LA N 0 0 0 0 0 0 0 0  
20 Maine ME L 0 54,186,762 0 0 0 0 54,186,762 0  
21 Maryland MD N 0 0 0 0 0 0 0 0  
22 Massachusetts MA N 0 0 0 0 0 0 0 0  
23 Michigan MI N 0 0 0 0 0 0 0 0  
24 Minnesota MN N 0 0 0 0 0 0 0 0  
25 Mississippi MS N 0 0 0 0 0 0 0 0  
26 Missouri MO L 448 4,442,477 0 0 0 0 4,442,925 0  
27 Montana MT N 0 0 0 0 0 0 0 0  
28 Nebraska NE N 0 0 0 0 0 0 0 0  
29 Nevada NV N 0 0 0 0 0 0 0 0  
30 New Hampshire NH L 0 19,149,522 0 0 0 0 19,149,522 0  
31 New Jersey NJ N 0 0 0 0 0 0 0 0  
32 New Mexico NM N 0 0 0 0 0 0 0 0  
33 New York NY N 0 0 0 0 0 0 0 0  
34 North Carolina NC N 0 0 0 0 0 0 0 0  
35 North Dakota ND N 0 0 0 0 0 0 0 0  
36 Ohio OH N 0 0 0 0 0 0 0 0  
37 Oklahoma OK N 0 0 0 0 0 0 0 0  
38 Oregon OR N 0 0 0 0 0 0 0 0  
39 Pennsylvania PA N 0 0 0 0 0 0 0 0  
40 Rhode Island RI N 0 0 0 0 0 0 0 0  
41 South Carolina SC L 0 49,185,561 0 0 0 0 49,185,561 0  
42 South Dakota SD N 0 0 0 0 0 0 0 0  
43 Tennessee TN N 0 0 0 0 0 0 0 0  
44 Texas TX L 7,680 36,608,052 0 0 0 0 36,615,732 0  
45 Utah UT N 0 0 0 0 0 0 0 0  
46 Vermont VT N 0 0 0 0 0 0 0 0  
47 Virginia VA L 0 -152,449 0 0 0 0 -152,449 0  
48 Washington WA L 0 48,650,166 0 0 0 0 48,650,166 0  
49 West Virginia WV L 0 0 0 0 0 0 0 0  
50 Wisconsin WI N 0 0 0 0 0 0 0 0  
51 Wyoming WY N 0 0 0 0 0 0 0 0  
52 American Samoa AS N 0 0 0 0 0 0 0 0  
53 Guam GU N 0 0 0 0 0 0 0 0  
54 Puerto Rico PR N 0 0 0 0 0 0 0 0  
55 U.S. Virgin Islands VI N 0 0 0 0 0 0 0 0  
56 Northern Mariana Islands MP N 0 0 0 0 0 0 0 0  
57 Canada CAN N 0 0 0 0 0 0 0 0  
58 Aggregate other alien OT   0 0 0 0 0 0 0 0  
59 Subtotal   8,128 227,523,361 0 0 0 0 227,531,489 0  
60 Reporting entity contributions for Employee Benefit Plans   0 0 0 0 0 0 0 0  
61 Totals 12 8,128 227,523,361 0 0 0 0 227,531,489 0  
Details of Write-Ins
58999     0 0 0 0 0 0 0 0  
FootNotes
0000001 Explanation of basis of allocation by states, premiums by states, etc. THE COMPANY ALLOCATES PREMIUM BASED UPON THE SITUS OF THE CONTRACT.

Last Updated: March 3, 2014