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2013 LIABILITIES, CAPITAL AND SURPLUS - 003
52618 - Anthem Hlth Plans of ME Inc
Quarter 3

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 11/19/2013
Line Quarter Number Covered Current Period Uncovered Current Period Total Current Period Total Prior Year
01 Claims unpaid (less $2188489 reinsurance ceded) 3 80,204,298 395,292 80,599,590 91,790,104
02 Accrued medical incentive pool and bonus amounts 3 0 0 0 0
03 Unpaid claims adjustment expenses 3 2,119,972 0 2,119,972 2,262,466
04 Aggregate health policy reserves, including the liability of $0 for medical loss ratio rebate per the Public Health Service Act 3 97,227,685 0 97,227,685 85,957,352
05 Aggregate life policy reserves 3 0 0 0 0
06 Property/casualty unearned premium reserve 3 0 0 0 0
07 Aggregate health claim reserves 3 1,336,047 0 1,336,047 1,384,446
08 Premiums received in advance 3 15,772,838 0 15,772,838 16,064,595
09 General expenses due or accrued 3 4,955,969 0 4,955,969 8,432,132
10.1 Current federal and foreign income tax payable and interest thereon (including $0 on realized capital gains (losses)) 3 2,999,541 0 2,999,541 3,045,501
10.2 Net deferred tax liability 3 0 0 0 0
11 Ceded reinsurance premiums payable 3 782,531 0 782,531 672,353
12 Amounts withheld or retained for the account of others 3 353,765 0 353,765 366,272
13 Remittances and items not allocated 3 2,280,074 0 2,280,074 4,538,499
14 Borrowed money (including $0 current) and interest thereon $0 (including $0 current) 3 0 0 0 0
15 Amounts due to parent, subsidiaries and affiliates 3 4,993,860 0 4,993,860 40,348,820
16 Derivatives 3 0 0 0 0
17 Payable for securities 3 0 0 0 0
18 Payable for securities lending 3 0 0 0 0
19 Funds held under reinsurance treaties with ($0 authorized reinsurers, $0 unauthorized reinsurers and $0 certified reinsurers) 3 0 0 0 0
20 Reinsurance in unauthorized and certified ($0) companies 3 0 0 0 0
21 Net adjustments in assets and liabilities due to foreign exchange rates 3 0 0 0 0
22 Liability for amounts held under uninsured plans 3 5,559,897 0 5,559,897 10,103,547
23 Aggregate write-ins for other liabilities (including $4612218 current) 3 11,139,960 0 11,139,960 7,117,297
24 Total liabilities (Lines 1 to 23) 3 229,726,437 395,292 230,121,729 272,083,384
25 Aggregate write-ins for special surplus funds 3     0 0
26 Common capital stock 3     2,500,000 2,500,000
27 Preferred capital stock 3     0 0
28 Gross paid in and contributed surplus 3     120,652,900 120,652,900
29 Surplus notes 3     0 0
30 Aggregate write-ins for other than special surplus funds 3     0 0
31 Unassigned funds (surplus) 3     72,477,313 19,636,477
32.1 (1) shares common (value included in common capital stock $0) (less treasury stock, at cost) 3     0 0
32.2 (1) shares preferred (value included in preferred capital stock $0) (less treasury stock, at cost) 3     0 0
33 Total capital and surplus 3     195,630,213 142,789,377
34 Total liabilities, capital and surplus 3     425,751,942 414,872,761
Details of Write-Ins
2301 FEP SPECIAL ADVANCE 3 4,353,675 0 4,353,675 4,353,675
2302 BLUE CARD LIABILITIES 3 3,136,027 0 3,136,027 305,358
2303 ESCHEAT LIABILITY 3 1,275,038 0 1,275,038 1,099,343
2304 OTHER LIABILITIES 3 1,156,096 0 1,156,096 348,321
2305 PERFORMANCE GUARANTEES 3 630,816 0 630,816 437,225
2306 RETROACTIVITY LIABILITY 3 588,308 0 588,308 573,375
2399   3 11,139,960 0 11,139,960 7,117,297
2599   3     0 0
3099   3     0 0

Last Updated: November 20, 2013