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2010 Financial Results for Health Insurance Companies in Maine
(Detailed version)

The following tables show Maine data reported by leading health insurers and health maintenance organizations (HMOs) that provide medical expense insurance in Maine. Data is shown separately for each of three market segments: large group (employers with more than 50 employees), small group (employers with 50 or fewer employees), and individual (people who are not covered by an employer plan and buy coverage directly). Grand totals are shown for each market segment. The data does not include stop loss, accidental injury, specified disease, hospital indemnity, Medicare Supplement, disability income, long-term care or other limited benefit coverage. In some cases, companies in the same group are presented together in one table. The “All Other Companies” table for each market segment provides aggregate data for companies with less than $2 million in direct written medical expense premium in the State of Maine. These “All Other Companies” tables do not include enrollment and per member per month data because these companies are not required to report it. While the Bureau checks this data for consistency with other reported information, we cannot vouch for the accuracy of the data.

Here is a list of the items contained in the tables below along with a description of the items:

(1) Number of Covered Lives, Dec. 31: This is the number of people (including dependents) who were covered as of the end of the year.

(2) Member Months during Year: This the sum of the number of people covered during each month during the year. One person covered for the whole year represents 12 member months.

(3) Number of Contracts issued in 2010: This is the number of individual or group policies issued during the year and still in force at the end of the year.

(4) Number of contracts issued in 2010 covering policyholders who were uninsured for the prior 90 days: This is the number of individual policies issued to previously uninsured individuals and the number issued to small groups that did not have a previous health plan in the prior 90 days. Some carriers were unable to report this data.

(5) Premiums Earned: This is the amount paid for coverage during the year regardless of when it was paid. For example, premiums paid in December 2009 for coverage in January 2010 are included in 2010 premiums earned but premiums paid in December 2010 for coverage in January 2011 are not included.

(6) Claims Incurred: This is the amount paid for medical services provided during the year regardless of when it was paid. For example, claims paid in January 2010 for services provided in December 2009 are included in 2009 claims incurred but claims paid in January 2011 for services provided in December 2010 are included in 2010 claims incurred. Claims incurred are also shown as a percentage of premium. This is commonly called the “loss ratio” and is sometimes considered a measure of how good a value is received for the premium paid. However, it can be misleading. For example, an insurer that has healthier policyholders, on average, than another insurer may have a lower loss ratio even though it may charge less for similar coverage. Also, if the volume of business is small, experience is subject to random fluctuations.

(7) Increase in Policy Reserves: Policy reserves are held when future premiums are not expected to be sufficient to cover future claims. For example, some types of insurance policies have premiums based on the age when the policy was issued. Even though claims are expected to increase as the person ages, the premiums will not reflect this, so part of the premium in the early years is held in a reserve to cover later claims. This is generally not the case for medical expense insurance and therefore policy reserves are generally not a significant item.

(8) Administrative Expenses: This includes all expenses reported on the companies’ annual financial statement other than claims. Administrative expenses include office space, salaries, utilities, postage, office supplies, commissions, marketing, advertising, cost containment expenses, lobbying expenses, taxes (other than federal income tax), and other expenses. Cost containment expenses are expenses that reduce the amount of health care services provided, including utilization review, fraud prevention and detection, provider contracting, provider network development, smoking cessation programs, disease management programs, and case management.

(9) Underwriting Gain or (Loss): This is the amount of premium left over (or the shortfall) after claims and administrative expenses are paid and any needed increase is added to policy reserves. Underwriting gain differs somewhat from “profit” in that it does not reflect certain items, primarily income from investments, capital gains and losses, and federal income taxes.

(10) Premium per Member Month: This is the average monthly premium per person. It should be noted that policies vary widely with respect to features such as deductibles, copayments, policy limits, and restricted provider networks. Therefore comparing the average premium for different companies or different market segments may be comparing “apples and oranges.” Also shown is the percentage increase (or decrease) from the prior year’s average premium. Here again, the comparison may reflect differing benefit levels. As rates increase, some employers and individuals increase their deductible or make other modifications to their policies in order to reduce the amount of the increase.

(11) Claims per Member Month: This is the average amount of monthly claims per person. Also shown is the percentage increase (or decrease) from the prior year’s average claims. The notes above concerning premium per member month apply equally here. The actual trend in health care costs may be more than the trend in claims because the claims trend may reflect a reduction in benefit levels such as an increased deductible.

The Annual Report Supplements (945 Reports) for Maine’s larger insurers is available on the Bureau of Insurance website. Here is the link: http://www.maine.gov/pfr/insurance/consumer/rule945reports.htm.

Large Group
Aetna (Aetna Health Inc + Aetna Life Ins Co)
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	17,598		28,881		33,666
(2) Member Months During Year	229,463		384,849		400,315
(3) Number of Contracts issued during year	16		9		20
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$94,236,142	100%	$151,435,959	100%	$154,912,707	100%
(6) Claims Incurred	$78,658,937	83%	$124,670,678	82%	$120,262,405	78%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$12,716,658	13%	$24,458,560	16%	$21,515,817	14%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$2,860,547	3%	$2,306,721	2%	$13,134,485	8%
(10a) Premium per Member Month [(5)/(2)]	$411		$393		$387
(10b) Premium Trend [(10a)/(10a prior year)-1]	4%		2%		9%
(11a) Claims per Member Month [(6)/(2)]	$343		$324		$300
(11b) Claims Trend [(11a)/(11a prior year)-1]	6%		8%		6%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
Anthem Health Plans of ME Inc
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	137,497		135,852		138,456
(2) Member Months During Year	1,658,211		1,637,612		1,676,611
(3) Number of Contracts issued during year	0		0		0
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$673,974,416	100%	$654,851,523	100%	$635,899,126	100%
(6) Claims Incurred	$597,704,671	89%	$588,409,990	90%	$561,612,832	88%
(7) Increase in Policy Reserves	0	0%	0	0%	($15,698)	0%
(8) Administrative Expenses	$48,505,094	7%	$49,881,655	8%	$40,852,804	6%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$27,764,651	4%	$16,559,878	3%	$33,449,188	5%
(10a) Premium per Member Month [(5)/(2)]	$406		$400		$379
(10b) Premium Trend [(10a)/(10a prior year)-1]	2%		5%		5%
(11a) Claims per Member Month [(6)/(2)]	$360		$359		$335
(11b) Claims Trend [(11a)/(11a prior year)-1]	0%		7%		7%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
Connecticut General Life Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	26,726		23,359		27,750
(2) Member Months During Year	320,504		291,203		339,871
(3) Number of Contracts issued during year	60		36		399
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$143,487,477	100%	$140,559,200	100%	$130,759,702	100%
(6) Claims Incurred	$113,714,738	79%	$100,260,740	71%	$98,277,156	75%
(7) Increase in Policy Reserves	$0	0%	$0	0%	0	0%
(8) Administrative Expenses	$9,769,038	7%	$10,873,167	8%	$8,436,629	6%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$20,003,701	14%	$29,425,292	21%	$24,045,917	18%
(10a) Premium per Member Month [(5)/(2)]	$448		$483		$385
(10b) Premium Trend [(10a)/(10a prior year)-1]	-7%		25%		15%
(11a) Claims per Member Month [(6)/(2)]	$355		$344		$289
(11b) Claims Trend [(11a)/(11a prior year)-1]	3%		19%		2%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
Harvard Pilgrim (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	22,672		19,838		15,575
(2) Member Months During Year	266,289		218,037		178,546
(3) Number of Contracts issued during year	196		81		50
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$101,640,051	100%	$76,835,035	100%	$60,588,722	100%
(6) Claims Incurred	$89,807,234	88%	$68,921,549	90%	$53,107,244	88%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$17,030,539	17%	$12,178,562	16%	$8,468,459	14%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($5,197,722)	-5%	($4,265,076)	-6%	($986,981)	-2%
(10a) Premium per Member Month [(5)/(2)]	$382		$352		$339
(10b) Premium Trend [(10a)/(10a prior year)-1]	8%		4%		7%
(11a) Claims per Member Month [(6)/(2)]	$337		$316		$297
(11b) Claims Trend [(11a)/(11a prior year)-1]	7%		6%		7%
Source: Rule Chapter 945 Long Form Large Group Totals

Large Group
Nationwide Life Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	1,249		0		0
(2) Member Months During Year	2,860		0		0
(3) Number of Contracts issued during year	0		0		0
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$2,971,914	100%	$0	0%	$0	0%
(6) Claims Incurred	$1,065,174	36%	$0	0%	$0	0%
(7) Increase in Policy Reserves	$207,201	7%	$0	0%	$0	0%
(8) Administrative Expenses	$1,310,036	44%	$0	0%	$0	0%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$389,503	13%	$0	0%	$0	0%
(10a) Premium per Member Month [(5)/(2)]	$1,039		$0		$0
(10b) Premium Trend [(10a)/(10a prior year)-1]			0%		0%
(11a) Claims per Member Month [(6)/(2)]	$372		$0		$0
(11b) Claims Trend [(11a)/(11a prior year)-1]	0%		0%		0%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
United Healthcare Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	1,529		1,410		1,754
(2) Member Months During Year	17,374		17,808		20,848
(3) Number of Contracts issued during year	0		12		46
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$8,745,782	100%	$7,432,717	100%	$9,428,899	100%
(6) Claims Incurred	$6,914,692	79%	$5,967,397	80%	$7,636,442	81%
(7) Increase in Policy Reserves	$108,172	1%	$91,846	1%	$114,113	1%
(8) Administrative Expenses	$1,554,618	18%	$1,174,780	16%	$1,500,903	16%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$168,300	2%	$198,694	3%	$177,441	2%
(10a) Premium per Member Month [(5)/(2)]	$503		$417		$452
(10b) Premium Trend [(10a)/(10a prior year)-1]	21%		-8%		31%
(11a) Claims per Member Month [(6)/(2)]	$398		$335		$366
(11b) Claims Trend [(11a)/(11a prior year)-1]	19%		-9%		32%
Source: Rule Chapter 945 Long Form Large Group Totals

 

Large Group
All Other Companies
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31
(2) Member Months During Year
(3) Number of Contracts issued during year
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days
(5) Premiums Earned	$5,633,287	100%	$8,099,190	100%	$16,040,924	100%
(6) Claims Incurred	$3,349,668	59%	$5,226,243	65%	$11,833,873	74%
(7) Increase in Policy Reserves	($73,140)	-1%	($66,666)	-1%	($147,299)	-1%
(8) Administrative Expenses	$430,686	8%	$938,382	12%	$2,417,796	15%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$1,926,072	34%	$2,001,231	25%	$1,936,554	12%
(10a) Premium per Member Month [(5)/(2)]
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Large Group Totals for companies who are not displayed in the tables above. In addition, this table includes aggregate data for companies reporting on Rule Chapter 945 Short Form for Large Groups. Note: Some of the lines are left blank because companies reporting on the Short form are not required to complete them.

 

Large Group Grand Totals
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	207,271		209,902		217,201
(2) Member Months During Year	2,494,701		2,558,169		2,616,191
(3) Number of Contracts issued during year	272		138		515
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	NA		NA		NA
(5) Premiums Earned	$1,030,689,069	100%	$1,039,213,624	100%	$1,007,630,080	100%
(6) Claims Incurred	$891,215,114	86%	$893,456,598	86%	$852,729,952	85%
(7) Increase in Policy Reserves	$242,233	0%	$25,180	0%	($48,884)	0%
(8) Administrative Expenses	$91,316,670	9%	$99,505,107	10%	$83,192,406	8%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$47,915,053	5%	$46,226,739	4%	$71,756,605	7%
(10a) Premium per Member Month [(5)/(2)]	$413		$406		$385
(10b) Premium Trend [(10a)/(10a prior year)-1]	2%		5%		9%
(11a) Claims per Member Month [(6)/(2)]	$357		$349		$326
(11b) Claims Trend [(11a)/(11a prior year)-1]	2%		7%		8%
Source: Rule Chapter 945 Aggregate Totals for Long Form Large Group and Short Form Large Group Note: The Covered Lives total and the Contracts Issued total does not include companies reporting less than $2 million in premium. These companies are not required to report those figures.

 

Small Group
Aetna (Aetna Health Inc + Aetna Life Ins Co)
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	31,752		38,487		38,126
(2) Member Months During Year	428,716		447,233		438,628
(3) Number of Contracts issued during year	381		843		1,139
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	97		0		0
(5) Premiums Earned	$129,776,069	100%	$129,348,436	100%	$130,147,467	100%
(6) Claims Incurred	$114,272,664	88%	$111,212,840	86%	$98,302,208	76%
(7) Increase in Policy Reserves	$0	0%	($573,223)	0%	$573,223	0%
(8) Administrative Expenses	$12,136,571	9%	$15,955,070	12%	$16,755,125	13%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$3,366,835	3%	$2,753,749	2%	$14,516,911	11%
(10a) Premium per Member Month [(5)/(2)]	$303		$289		$297
(10b) Premium Trend [(10a)/(10a prior year)-1]	5%		-3%		-4%
(11a) Claims per Member Month [(6)/(2)]	$267		$249		$224
(11b) Claims Trend [(11a)/(11a prior year)-1]	7%		11%		-5%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Anthem Health Plans of ME Inc
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	50,765		47,383		51,704
(2) Member Months During Year	583,112		584,390		649,735
(3) Number of Contracts issued during year	2,968		3,237		3,947
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	387		418		450
(5) Premiums Earned	$210,933,205	100%	$207,912,903	100%	$225,316,648	100%
(6) Claims Incurred	$170,897,672	81%	$177,106,931	85%	$184,386,716	82%
(7) Increase in Policy Reserves	$0	0%	$0	0%	($1,143)	0%
(8) Administrative Expenses	$26,023,964	12%	$26,740,599	13%	$29,112,559	13%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$14,011,569	7%	$4,065,373	2%	$11,818,516	5%
(10a) Premium per Member Month [(5)/(2)]	$362		$356		$347
(10b) Premium Trend [(10a)/(10a prior year)-1]	2%		3%		9%
(11a) Claims per Member Month [(6)/(2)]	$293		$303		$284
(11b) Claims Trend [(11a)/(11a prior year)-1]	-3%		7%		13%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Connecticut General Life Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	27		9
(2) Member Months During Year	348		135
(3) Number of Contracts issued during year	1		1
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0
(5) Premiums Earned	$143,631	100%	$112,650	100%
(6) Claims Incurred	$91,504	64%	$168,412	150%
(7) Increase in Policy Reserves	$0	0%	$0	0%
(8) Administrative Expenses	$9,485	7%	$8,878	8%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$42,642	30%	($64,640)	-57%
(10a) Premium per Member Month [(5)/(2)]	$413		$834
(10b) Premium Trend [(10a)/(10a prior year)-1]	-51%
(11a) Claims per Member Month [(6)/(2)]	$263		$1,247
(11b) Claims Trend [(11a)/(11a prior year)-1]	-79%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Harvard Pilgrim Health Care (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	13,324		11,205		14,171
(2) Member Months During Year	138,004		131,618		137,342
(3) Number of Contracts issued during year	2,158		1,617		1,728
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	11		0		3
(5) Premiums Earned	$57,841,244	100%	$51,954,592	100%	$50,838,450	100%
(6) Claims Incurred	$46,546,338	80%	$46,670,374	90%	$43,811,855	86%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$8,452,290	15%	$6,563,694	13%	$6,592,694	13%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$2,842,615	5%	($1,279,476)	-2%	$433,901	1%
(10a) Premium per Member Month [(5)/(2)]	$419		$395		$370
(10b) Premium Trend [(10a)/(10a prior year)-1]	6%		7%		13%
(11a) Claims per Member Month [(6)/(2)]	$337		$355		$319
(11b) Claims Trend [(11a)/(11a prior year)-1]	-5%		11%		6%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
Mega Life & Health Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	1,560		1,759		2,115
(2) Member Months During Year	18,625		22,559		27,143
(3) Number of Contracts issued during year	3		0		7
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		0
(5) Premiums Earned	$3,639,783	100%	$4,393,110	100%	$5,475,463	100%
(6) Claims Incurred	$2,558,030	70%	$3,365,547	77%	$3,374,753	62%
(7) Increase in Policy Reserves	($502,267)	-14%	$239,987	5%	($241,361)	-4%
(8) Administrative Expenses	$855,444	24%	$1,073,683	24%	$2,320,873	42%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$728,576	20%	($286,107)	-7%	$21,198	0%
(10a) Premium per Member Month [(5)/(2)]	$195		$195		$202
(10b) Premium Trend [(10a)/(10a prior year)-1]	0%		-3%		-8%
(11a) Claims per Member Month [(6)/(2)]	$137		$149		$124
(11b) Claims Trend [(11a)/(11a prior year)-1]	-8%		20%		3%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
United Healthcare Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	284		300		498
(2) Member Months During Year	3,380		3,930		6,175
(3) Number of Contracts issued during year	0		0		6
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		0
(5) Premiums Earned	$1,401,495	100%	$1,120,941	100%	$1,723,528	100%
(6) Claims Incurred	$867,018	62%	$757,518	68%	$1,157,489	67%
(7) Increase in Policy Reserves	$11,870	1%	$12,412	1%	$18,156	1%
(8) Administrative Expenses	$308,329	22%	$269,026	24%	$413,647	24%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$214,277	15%	$81,985	7%	$134,236	8%
(10a) Premium per Member Month [(5)/(2)]	$415		$285		$279
(10b) Premium Trend [(10a)/(10a prior year)-1]	45%		2%		-16%
(11a) Claims per Member Month [(6)/(2)]	$257		$193		$187
(11b) Claims Trend [(11a)/(11a prior year)-1]	33%		3%		-29%
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals.

 

Small Group
All Other Companies
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31
(2) Member Months During Year
(3) Number of Contracts issued during year
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days
(5) Premiums Earned	$2,598,417	100%	$1,725,253	100%	$1,561,846	100%
(6) Claims Incurred	$1,148,963	44%	$1,159,866	67%	$1,026,985	65%
(7) Increase in Policy Reserves	$15,271	1%	($23,142)	-1%	($170,608)	-11%
(8) Administrative Expenses	$564,082	22%	$456,319	26%	$471,386	31%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$870,100	33%	$132,210	8%	$234,083	14%
(10a) Premium per Member Month [(5)/(2)]
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Small Group and Dirigo Small Group Totals for companies who are not displayed in the tables above. In addition, this table includes aggregate data for companies reporting on Rule Chapter 945 Short Form for Large Groups. Note: Some of the lines are left blank because companies reporting on the Short form are not required to complete them.

 

Small Group Grand Totals
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	97,712		99,143		106,514
(2) Member Months During Year	1,172,184		1,189,865		1,259,023
(3) Number of Contracts issued during year	5,511		5,698		1,100
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	495		418		453
(5) Premiums Earned	$406,333,843	100%	$396,567,885	100%	$415,063,402	100%
(6) Claims Incurred	$336,382,190	83%	$340,441,488	86%	$332,060,006	81%
(7) Increase in Policy Reserves	($475,126)	0%	($343,965)	0%	$178,267	0%
(8) Administrative Expenses	$48,350,164	12%	$51,067,268	13%	$55,666,284	14%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$22,076,615	5%	$5,403,094	1%	$27,158,845	5%
(10a) Premium per Member Month [(5)/(2)]	$347		$333		$330
(10b) Premium Trend [(10a)/(10a prior year)-1]	4%		1%		6%
(11a) Claims per Member Month [(6)/(2)]	$287		$286		$264
(11b) Claims Trend [(11a)/(11a prior year)-1]	0%		8%		6%
Source: Rule Chapter 945 Aggregate Long Form Small Group and Dirigo Small Group Totals. Note: The Covered Lives total, the Contracts Issued total, and the total number of contracts issued during the year covering policyholders that were uninsured for the prior 90 days does not include companies reporting less than $2 million in premium. These companies are not required to report those figures.

 

Individual
Aetna (Aetna Health Inc + Aetna Life Ins Co)
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	45		52		45
(2) Member Months During Year	602		621		593
(3) Number of Contracts issued during year	0		0		0
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		0
(5) Premiums Earned	$244,370	100%	$203,870	100%	$130,832	100%
(6) Claims Incurred	$380,630	156%	$570,104	280%	$361,754	277%
(7) Increase in Policy Reserves	$36,118	15%	$0	0%	($20,398)	-16%
(8) Administrative Expenses	$61,932	25%	$30,628	15%	$20,408	16%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($234,310)	-96%	($396,862)	-195%	($230,932)	-177%
(10a) Premium per Member Month [(5)/(2)]	$406		$328		$221
(10b) Premium Trend [(10a)/(10a prior year)-1]	24%		48%		65%
(11a) Claims per Member Month [(6)/(2)]	$632		$918		$610
(11b) Claims Trend [(11a)/(11a prior year)-1]	-31%		50%		97%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
Anthem Health Plans of ME Inc
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	17,503		19,298		21,290
(2) Member Months During Year	220,711		243,617		264,312
(3) Number of Contracts issued during year	794		939		636
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	239		290		226
(5) Premiums Earned	$62,088,316	100%	$64,365,540	100%	$67,172,619	100%
(6) Claims Incurred	$54,400,212	88%	$60,428,948	94%	$56,806,645	85%
(7) Increase in Policy Reserves	($6,347,696)	-10%	$6,347,696	10%	($3,285)	0%
(8) Administrative Expenses	$6,720,874	11%	$6,974,880	11%	$6,738,661	10%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$7,314,926	12%	($9,385,984)	-15%	$3,630,598	5%
(10a) Premium per Member Month [(5)/(2)]	$281		$264		$254
(10b) Premium Trend [(10a)/(10a prior year)-1]	6%		4%		-19%
(11a) Claims per Member Month [(6)/(2)]	$246		$248		$215
(11b) Claims Trend [(11a)/(11a prior year)-1]	-1%		15%		-22%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
Connecticut General Life Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	6		0		13
(2) Member Months During Year	72		0		176
(3) Number of Contracts issued during year	0		0		0
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0		0		0
(5) Premiums Earned	$40,030	100%	$0		$0
(6) Claims Incurred	$46,957	117%	$0		$0
(7) Increase in Policy Reserves	$0	0%	$0		$0
(8) Administrative Expenses	$2,734	7%	$0		$0
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	($9,661)	-24%	$0		$0
(10a) Premium per Member Month [(5)/(2)]	$556
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]	$652
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
Harvard Pilgrim (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company)
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	4,963		6,088		7,821
(2) Member Months During Year	62,186		81,631		106,165
(3) Number of Contracts issued during year	3,293		3,895		4,992
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	0
(5) Premiums Earned	$38,262,645	100%	$47,821,277	100%	$55,079,470	100%
(6) Claims Incurred	$31,432,220	82%	$38,387,454	80%	$49,853,050	91%
(7) Increase in Policy Reserves	$0	0%	$0	0%	$0	0%
(8) Administrative Expenses	$3,239,048	8%	$3,148,997	7%	$5,218,193	9%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$3,591,377	9%	$6,284,826	13%	$8,227	0%
(10a) Premium per Member Month [(5)/(2)]	$615		$586		$519
(10b) Premium Trend [(10a)/(10a prior year)-1]	5%		13%		-54%
(11a) Claims per Member Month [(6)/(2)]	$505		$470		$470
(11b) Claims Trend [(11a)/(11a prior year)-1]	7%		0%		-86%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals. Note: (4) was left blank on the report.

 

Individual
Mega Life & Health Ins Co
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	12,969		12,607		11,285
(2) Member Months During Year	133,794		139,755		123,703
(3) Number of Contracts issued during year	2,263		3,440		2,661
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	272		0		0
(5) Premiums Earned	$30,384,463	100%	$25,818,266	100%	$21,549,601	100%
(6) Claims Incurred	$18,616,519	61%	$16,652,464	64%	$13,365,760	62%
(7) Increase in Policy Reserves	$224,829	1%	$629,368	2%	$1,477,425	7%
(8) Administrative Expenses	$8,741,654	29%	$10,162,300	39%	$9,135,343	42%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$2,801,461	9%	($1,625,866)	-6%	($2,428,927)	-11%
(10a) Premium per Member Month [(5)/(2)]	$227		$185		$174
(10b) Premium Trend [(10a)/(10a prior year)-1]	23%		6%		4%
(11a) Claims per Member Month [(6)/(2)]	$139		$119		$108
(11b) Claims Trend [(11a)/(11a prior year)-1]	17%		10%		21%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals.

 

Individual
All other companies
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31
(2) Member Months During Year
(3) Number of Contracts issued during year
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days
(5) Premiums Earned	$8,645,854	100%	$4,345,395	100%	$3,876,833	100%
(6) Claims Incurred	$3,367,320	39%	$3,547,684	82%	$2,319,598	60%
(7) Increase in Policy Reserves	$171,509	2%	$40,541	1%	$63,634	2%
(8) Administrative Expenses	$4,546,195	53%	$835,376	19%	$811,745	21%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$560,831	6%	($80,067)	-2%	$681,857	18%
(10a) Premium per Member Month [(5)/(2)]
(10b) Premium Trend [(10a)/(10a prior year)-1]
(11a) Claims per Member Month [(6)/(2)]
(11b) Claims Trend [(11a)/(11a prior year)-1]
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual for companies who are not displayed in the tables above. In addition, this table includes aggregate data for companies reporting on Rule Chapter 945 Short Form for Individual and Dirigo Individual.

 

Individual Grand Totals
Insurer	2010		2009		2008
	Amount	% of Premium	Amount	% of Premium	Amount	% of Premium
(1) Number of Covered Lives, Dec. 31	35,486		38,055		40,454
(2) Member Months During Year	417,365		465,725		494,949
(3) Number of Contracts issued during year	6,350		8,274		8,289
(4) Number of contracts issued during year covering policyholders that were uninsured for the prior 90 days	511		290		226
(5) Premiums Earned	$139,665,678	100%	$142,590,961	100%	$147,809,355	100%
(6) Claims Incurred	$108,243,858	78%	$119,604,001	84%	$122,706,807	83%
(7) Increase in Policy Reserves	($5,915,240)	-4%	$7,017,605	5%	$1,517,376	1%
(8) Administrative Expenses	$23,312,436	17%	$21,152,181	15%	$21,924,350	15%
(9) Underwriting Gain or (Loss) [(5)-(6)-(7)-(8)]	$14,024,625	10%	($5,182,825)	-4%	$1,660,823	1%
(10a) Premium per Member Month [(5)/(2)]	$335		$306		$299
(10b) Premium Trend [(10a)/(10a prior year)-1]	9%		3%		6%
(11a) Claims per Member Month [(6)/(2)]	$259		$257		$248
(11b) Claims Trend [(11a)/(11a prior year)-1]	1%		4%		5%
Source: Rule Chapter 945 Long Form Individual and Dirigo Individual Totals and Rule Chapter 945 Short Form Individual and Dirigo Individual Totals for Premiums Earned, Claims Incurred, Increase in Policy Reserves, Administrative Expenses, and Underwriting Gain or Loss. Note: The Covered Lives, the Contracts Issued, and the Number of Contracts Covering Previously Uninsured totals do not include companies reporting less than $2 million in premium. These companies are not required to report those figures.

 

 

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