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2013 EXHIBIT OF PREMIUMS, ENROLLMENT AND UTILIZATION - 007
95447 - Cigna Hlthcare of ME Inc
Quarter 3

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 11/19/2013
Line Quarter Number Total Individual Comprehensive Group Comprehensive Medicare Supplement Vision Only Dental Only Federal Employees Health Benefit Plan Title XVIII Medicare Title XIX Medicaid Other
01 Prior Year (total member at end of) 3 0 0 0 0 0 0 0 0 0 0
02 First Quarter (total members at end of) 3 0 0 0 0 0 0 0 0 0 0
03 Second Quarter (total members at end of) 3 0 0 0 0 0 0 0 0 0 0
04 Third Quarter (total members at end of) 3 0 0 0 0 0 0 0 0 0 0
05 Current Year (total members at end of) 3 0 0 0 0 0 0 0 0 0 0
06 Current Year Member Months 3 0 0 0 0 0 0 0 0 0 0
07 Physician (total member ambulatory encounters) 3 0 0 0 0 0 0 0 0 0 0
08 Non-physician (total member ambulatory encounters) 3 0 0 0 0 0 0 0 0 0 0
09 Total (total member ambulatory encounters) 3 0 0 0 0 0 0 0 0 0 0
10 Hospital patient days incurred 3 0 0 0 0 0 0 0 0 0 0
11 Number of inpatient admissions 3 0 0 0 0 0 0 0 0 0 0
12 Health premiums written (a) 3 0 0 0 0 0 0 0 0 0 0
13 Life premiums direct 3 0 0 0 0 0 0 0 0 0 0
14 Property/casualty premiums written 3 0 0 0 0 0 0 0 0 0 0
15 Health premiums earned 3 0 0 0 0 0 0 0 0 0 0
16 Property/casualty premiums earned 3 0 0 0 0 0 0 0 0 0 0
17 Amount paid for provision of health care services 3 -6,034 0 -6,034 0 0 0 0 0 0 0
18 Amount incurred for provision of health care services 3 -6,034 0 -6,034 0 0 0 0 0 0 0
FootNotes
0000001 (a) For health premiums written: amount of Medicare Title XVIII exempt from state taxes or fees $0
0000001 (a) For health premiums written: amount of Medicare Title XVIII exempt from state taxes or fees $0
0000001 (a) For health premiums written: amount of Medicare Title XVIII exempt from state taxes or fees $0

Last Updated: November 19, 2013