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2013 LIABILITIES, CAPITAL AND SURPLUS - 003
12545 - Martins Point Generations LLC

OLTPPROD Copyright 2014 National Association of Insurance Commissioners. All rights reserved. 03/04/2014
Line
Covered Current Year
Uncovered Current Year
Total Current Year
Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 20,029,104 0 20,029,104 15,815,292
02 Accrued medical incentive pool and bonus amounts 611,224 0 611,224 334,926
03 Unpaid claims adjustment expenses 661,048 0 661,048 404,982
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 0 0 0 0
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 299,552 0 299,552 219,333
09 General expenses due or accrued 542,279 0 542,279 474,540
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 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 404,595 0 404,595 7,804
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 391,418 0 391,418 492,808
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 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 0 0 0 0
24 Total liabilities (Lines 1 to 23) 22,939,220 0 22,939,220 17,749,685
25 Aggregate write-ins for special surplus funds     0 0
26 Common capital stock     0 0
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     59,500,000 43,500,000
29 Surplus notes     0 0
30 Aggregate write-ins for other-than-special surplus funds     0 0
31 Unassigned funds (surplus)     -41,793,155 -29,603,783
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     17,706,845 13,896,217
34 Total liabilities, capital and surplus     40,646,065 31,645,902
Details of Write-Ins
2301   0 0 0 0
2302   0 0 0 0
2303   0 0 0 0
2399   0 0 0 0
2501       0 0
2502       0 0
2503       0 0
2599       0 0
3001       0 0
3002       0 0
3003       0 0
3099       0 0

Last Updated: March 4, 2014