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2013 LIABILITIES, CAPITAL AND SURPLUS - 003
13627 - SelectCare of ME Inc

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) 0 0 0 0
02 Accrued medical incentive pool and bonus amounts 0 0 0 0
03 Unpaid claims adjustment expenses 0 0 0 0
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 0 0 0 0
09 General expenses due or accrued 0 0 0 0
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 0 0 0 1,052
10.2 Net deferred tax liability 0 35 35 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 0 4,673 4,673 2,222
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) 0 4,708 4,708 3,274
25 Aggregate write-ins for special surplus funds     0 0
26 Common capital stock     1,000 1,000
27 Preferred capital stock     0 0
28 Gross paid in and contributed surplus     1,519,000 1,519,000
29 Surplus notes     0 0
30 Aggregate write-ins for other-than-special surplus funds     0 0
31 Unassigned funds (surplus)     1,976 1,957
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     1,521,976 1,521,957
34 Total liabilities, capital and surplus     1,526,684 1,525,231
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

 

2013 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
13627 - SelectCare of ME Inc

OLTPPROD Copyright 2014 National Association of Insurance Commissioners. All rights reserved. 03/04/2014
Line
Current Year
Prior Year
33 Capital and surplus prior reporting year 1,521,957 1,521,094
34 Net income or (loss) from Line 32 53 863
35 Change in valuation basis of aggregate policy and claim reserves 0 0
36 Change in net unrealized capital gains (losses) less capital gains tax of $0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 0 0
38 Change in net deferred income tax -35 0
39 Change in nonadmitted assets 0 0
40 Change in unauthorized and certified reinsurance 0 0
41 Change in treasury stock 0 0
42 Change in surplus notes 0 0
43 Cumulative effect of changes in accounting principles 0 0
44.1 Paid in (capital changes) 0 0
44.2 Transferred from surplus (stock dividend) (capital changes) 0 0
44.3 Transferred to surplus (capital changes) 0 0
45.1 Paid in (surplus adjustments) 0 0
45.2 Transferred to capital (stock dividend) (surplus adjustments) 0 0
45.3 Transferred from capital (surplus adjustments) 0 0
46 Dividends to stockholders 0 0
47 Aggregate write-ins for gains or (losses) in surplus 0 0
48 Net change in capital and surplus 18 863
49 Capital and surplus end of reporting year 1,521,975 1,521,957
Details of Write-Ins
4799   0 0

 

 

Last Updated: March 4, 2014