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2013 LIABILITIES, CAPITAL AND SURPLUS - 003
95517 - Aetna Hlth Inc ME Corp
Quarter 1

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 08/20/2013
Line Quarter Number Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $0 reinsurance ceded) 1 8,511,622 324,328 8,835,950 7,427,685
02 Accrued medical incentive pool and bonus amounts 1 289,215 0 289,215 231,372
03 Unpaid claims adjustment expenses 1 151,509 0 151,509 147,635
04 Aggregate health policy reserves, including the liability of $694482 for medical loss ratio rebate per the Public Health Service Act 1 768,635 0 768,635 213,335
05 Aggregate life policy reserves 1 0 0 0 0
06 Property/casualty unearned premium reserve 1 0 0 0 0
07 Aggregate health claim reserves 1 82,809 0 82,809 69,354
08 Premiums received in advance 1 15,501 0 15,501 6,914
09 General expenses due or accrued 1 19,301 0 19,301 14,201
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 1 0 0 0 0
10.2 Net deferred tax liability 1 0 0 0 0
11 Ceded reinsurance premiums payable 1 0 0 0 0
12 Amounts withheld or retained for the account of others 1 0 0 0 0
13 Remittances and items not allocated 1 0 0 0 0
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 1 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 1 1,000 0 1,000 4,556,051
16 Derivatives 1 0 0 0 0
17 Payable for securities 1 0 0 0 0
18 Payable for securities lending 1 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers, $0 unauthorized reinsurers and $0 certified reinsurers) 1 0 0 0 0
20 Reinsurance in unauthorized and certified ($0) companies 1 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 1 0 0 0 0
22 Liability for amounts held under uninsured plans 1 0 0 0 0
23 Aggregate write-ins for other liabilities (including $0 current) 1 120,897 0 120,897 111,882
24 Total liabilities (Lines 1 to 23) 1 9,960,489 324,328 10,284,817 12,778,429
25 Aggregate write-ins for special surplus funds 1     0 0
26 Common capital stock 1     1,000,000 1,000,000
27 Preferred capital stock 1     0 0
28 Gross paid in and contributed surplus 1     8,700,000 8,700,000
29 Surplus notes 1     0 0
30 Aggregate write-ins for other than special surplus funds 1     0 0
31 Unassigned funds (surplus) 1     4,436,736 5,118,026
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost) 1     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost) 1     0 0
33 Total capital and surplus 1     14,136,736 14,818,026
34 Total liabilities, capital and surplus 1     24,421,553 27,596,455
Details of Write-Ins
2301 CMS Coverage Gap Discount 1 87,660 0 87,660 104,569
2302 Medicare Part D Catastrophic Coverage Payable 1 29,329 0 29,329 0
2303 CMS Payable 1 1,968 0 1,968 0
2304 Other Payable 1 1,758 0 1,758 6,848
2305 Pharmacy Manufacturer's Discount Payable 1 182 0 182 465
2399   1 120,897 0 120,897 111,882
2501 Additional Deferred Tax Asset Admitted Amount 1     0 0
2599   1     0 0
3099   1     0 0

Last Updated: September 27, 2010