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2013 STATEMENT OF REVENUE AND EXPENSES - 004
12545 - Martins Point Generations LLC
Quarter 3

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 11/19/2013
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 3   206,036 145,887 199,950
02 Net premium income (including $0 non-health premium income) 3   127,969,375 98,675,650 132,098,338
03 Change in unearned premium reserves and reserve for rate credits 3   0 0 0
04 Fee-for-service (net of $0 medical expenses) 3   0 0 0
05 Risk revenue 3   0 0 0
06 Aggregate write-ins for other health care related revenues 3   0 0 0
07 Aggregate write-ins for other non-health revenues 3   0 0 0
08 Total revenues 3   127,969,375 98,675,650 132,098,338
09 Hospital/medical benefits (hospital and medical) 3 0 100,177,044 76,513,646 105,088,640
10 Other professional services (hospital and medical) 3 0 0 0 0
11 Outside referrals (hospital and medical) 3 0 0 0 0
12 Emergency room and out-of-area (hospital and medical) 3 0 0 0 0
13 Prescription drugs (hospital and medical) 3 0 18,776,775 13,690,450 16,757,112
14 Aggregate write-ins for other hospital and medical (hospital and medical) 3 0 0 0 0
15 Incentive pool, withhold adjustments and bonus amounts (hospital and medical) 3 0 950,676 242,196 546,293
16 Subtotal (hospital and medical) 3 0 119,904,495 90,446,292 122,392,045
17 Net reinsurance recoveries (less) 3 0 0 0 0
18 Total hospital and medical (less) 3 0 119,904,495 90,446,292 122,392,045
19 Non-health claims (net) (less) 3 0 0 0 0
20 Claims adjustment expenses, including $1086593 cost containment expenses (less) 3 0 2,303,067 2,218,258 2,644,702
21 General administrative expenses (less) 3 0 11,765,550 9,860,061 14,305,703
22 Increase in reserves for life and accident and health contracts (including $0 increase in reserves for life only) (less) 3 0 0 0 0
23 Total underwriting deductions 3 0 133,973,112 102,524,611 139,342,450
24 Net underwriting gain or (loss) 3   -6,003,737 -3,848,961 -7,244,112
25 Net investment income earned 3 0 23,770 14,969 18,164
26 Net realized capital gains (losses) less capital gains tax of $0 3 0 0 0 0
27 Net investment gains or (losses) 3 0 23,770 14,969 18,164
28 Net gain or (loss) from agents' or premium balances charged off [(amount recovered $0 (amount charged off $0] 3 0 0 0 0
29 Aggregate write-ins for other income or expenses 3 0 0 0 0
30 Net income or (loss) after capital gains tax and before all other federal income taxes 3   -5,979,967 -3,833,992 -7,225,948
31 Federal and foreign income taxes incurred 3   0 0 0
32 Net income (loss) 3   -5,979,967 -3,833,992 -7,225,948
Details of Write-Ins
0601   3   0 0 0
0602   3   0 0 0
0603   3   0 0 0
0699   3   0 0 0
0701   3   0 0 0
0702   3   0 0 0
0703   3   0 0 0
0799   3   0 0 0
1401   3 0 0 0 0
1402   3 0 0 0 0
1403   3 0 0 0 0
1499   3 0 0 0 0
2901   3 0 0 0 0
2902   3 0 0 0 0
2903   3 0 0 0 0
2999   3 0 0 0 0

 

2013 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
12545 - Martins Point Generations LLC
Quarter 3

OLTPPROD Copyright 2013 National Association of Insurance Commissioners. All rights reserved. 11/19/2013
Line Quarter Number Current Year to Date Prior Year to Date Prior Year Ended December 31
33 Capital and surplus prior reporting year 3 13,896,217 9,410,776 9,410,776
34 Net income or (loss) from Line 32 3 -5,979,967 -3,833,992 -7,225,948
35 Change in valuation basis of aggregate policy and claim reserves 3 0 0 0
36 Change in net unrealized capital gains (losses) less capital gains tax of $0 3 0 0 0
37 Change in net unrealized foreign exchange capital gain or (loss) 3 0 0 0
38 Change in net deferred income tax 3 0 0 0
39 Change in nonadmitted assets 3 -762,200 -875,156 -1,288,611
40 Change in unauthorized and certified reinsurance 3 0 0 0
41 Change in treasury stock 3 0 0 0
42 Change in surplus notes 3 0 0 0
43 Cumulative effect of changes in accounting principles 3 0 0 0
44.1 Paid in (capital changes) 3 8,500,000 4,200,000 13,000,000
44.2 Transferred from surplus (stock dividend) (capital changes) 3 0 0 0
44.3 Transferred to surplus (capital changes) 3 0 0 0
45.1 Paid in (surplus adjustments) 3 0 0 0
45.2 Transferred to capital (stock dividend) (surplus adjustments) 3 0 0 0
45.3 Transferred from capital (surplus adjustments) 3 0 0 0
46 Dividends to stockholders 3 0 0 0
47 Aggregate write-ins for gains or (losses) in surplus 3 0 0 0
48 Net change in capital and surplus 3 1,757,833 -509,148 4,485,441
49 Capital and surplus end of reporting period 3 15,654,050 8,901,628 13,896,217
Details of Write-Ins
4701   3 0 0 0
4702   3 0 0 0
4703   3 0 0 0
4799   3 0 0 0

 

 

 

 

 

 

Last Updated: November 19, 2013