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2013 STATEMENT OF REVENUE AND EXPENSES - 004
95447 - Cigna Hlthcare of ME Inc
Quarter 1

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 05/16/2013
Line
Quarter Number
Uncovered Current Year to Date
Total Current Year to Date
Total Prior Year to Date
Total Prior Year Ended December 31
01 Member months 1   0 0 0
02 Net premium income (including $0 non-health premium income) 1   0 407 411
03 Change in unearned premium reserves and reserve for rate credits 1   0 0 0
04 Fee-for-service (net of $0 medical expenses) 1   0 0 0
05 Risk revenue 1   0 0 0
06 Aggregate write-ins for other health care related revenues 1   0 0 0
07 Aggregate write-ins for other non-health revenues 1   0 0 0
08 Total revenues 1   0 407 411
09 Hospital/medical benefits (hospital and medical) 1 0 -2,767 400 0
10 Other professional services (hospital and medical) 1 0 0 -2,853 -3,806
11 Outside referrals (hospital and medical) 1 0 0 95 0
12 Emergency room and out-of-area (hospital and medical) 1 0 -542 -700 0
13 Prescription drugs (hospital and medical) 1 0 0 0 0
14 Aggregate write-ins for other hospital and medical (hospital and medical) 1 0 0 0 0
15 Incentive pool, withhold adjustments and bonus amounts (hospital and medical) 1 0 0 0 0
16 Subtotal (hospital and medical) 1 0 -3,309 -3,058 -3,806
17 Net reinsurance recoveries (less) 1 0 0 0 0
18 Total hospital and medical (less) 1 0 -3,309 -3,058 -3,806
19 Non-health claims (net) (less) 1 0 0 0 0
20 Claims adjustment expenses, including $0 cost containment expenses (less) 1 0 0 15 15
21 General administrative expenses (less) 1 0 1,170 122,182 150,500
22 Increase in reserves for life and accident and health contracts (including $0 increase in reserves for life only) (less) 1 0 0 0 0
23 Total underwriting deductions 1 0 -2,139 119,139 146,709
24 Net underwriting gain or (loss) 1   2,139 -118,732 -146,298
25 Net investment income earned 1 0 26,162 86,802 334,468
26 Net realized capital gains (losses) less capital gains tax of $2 1 0 3 -34 437,531
27 Net investment gains or (losses) 1 0 26,165 86,768 771,999
28 Net gain or (loss) from agents' or premium balances charged off [(amount recovered $0 (amount charged off $0] 1 0 0 0 0
29 Aggregate write-ins for other income or expenses 1 0 0 0 0
30 Net income or (loss) after capital gains tax and before all other federal income taxes 1   28,304 -31,964 625,701
31 Federal and foreign income taxes incurred 1   871 -37,858 -8,522
32 Net income (loss) 1   27,433 5,894 634,223
Details of Write-Ins
0601   1   0 0 0
0699   1   0 0 0
0799   1   0 0 0
1499   1 0 0 0 0
2999   1 0 0 0 0

2013 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
95447 - Cigna Hlthcare of ME Inc
Quarter 1

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 05/16/2013
Line
Quarter Number
Current Year to Date
Prior Year to Date
Prior Year Ended December 31
33 Capital and surplus prior reporting year 1 5,237,112 9,732,210 9,732,210
34 Net income or (loss) from Line 32 1 27,433 5,894 634,223
35 Change in valuation basis of aggregate policy and claim reserves 1 0 0 0
36 Change in net unrealized capital gains (losses) less capital gains tax of $0 1 0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 1 0 0 0
38 Change in net deferred income tax 1 -5,180 -5,237 -129,441
39 Change in nonadmitted assets 1 0 0 120
40 Change in unauthorized and certified reinsurance 1 0 0 0
41 Change in treasury stock 1 0 0 0
42 Change in surplus notes 1 0 0 0
43 Cumulative effect of changes in accounting principles 1 0 0 0
44.1 Paid in (capital changes) 1 0 0 0
44.2 Transferred from surplus (stock dividend) (capital changes) 1 0 0 0
44.3 Transferred to surplus (capital changes) 1 0 0 0
45.1 Paid in (surplus adjustments) 1 0 0 0
45.2 Transferred to capital (stock dividend) (surplus adjustments) 1 0 0 0
45.3 Transferred from capital (surplus adjustments) 1 0 0 0
46 Dividends to stockholders 1 0 0 -5,000,000
47 Aggregate write-ins for gains or (losses) in surplus 1 0 0 0
48 Net change in capital and surplus 1 22,253 657 -4,495,098
49 Capital and surplus end of reporting period 1 5,259,365 9,732,867 5,237,112
Details of Write-Ins
4799   1 0 0 0

 

 

 

Last Updated: November 20, 2013