|
Line |
Uncovered Current Year |
Total Current Year |
Total Prior Year |
| 01 |
Member months |
|
305,313 |
392,279 |
| 02 |
Net premium income (including $0 non-health premium
income) |
|
133,168,852 |
152,271,311 |
| 03 |
Change in unearned premium reserves and reserve for
rate credits |
|
37,320 |
46,459 |
| 04 |
Fee-for-service (net of $0 medical expenses) |
|
0 |
0 |
| 05 |
Risk revenue |
|
0 |
0 |
| 06 |
Aggregate write-ins for other health care related
revenues |
|
0 |
0 |
| 07 |
Aggregate write-ins for other non-health revenues |
|
0 |
0 |
| 08 |
Total revenues |
|
133,206,172 |
152,317,770 |
| 09 |
Hospital/medical benefits (hospital and medical) |
879,345 |
92,927,088 |
104,010,051 |
| 10 |
Other professional services (hospital and
medical) |
0 |
0 |
0 |
| 11 |
Outside referrals (hospital and medical) |
987,153 |
987,153 |
1,129,596 |
| 12 |
Emergency room and out-of-area (hospital and
medical) |
118,740 |
5,936,984 |
6,912,797 |
| 13 |
Prescription drugs (hospital and medical) |
0 |
14,198,951 |
16,171,330 |
| 14 |
Aggregate write-ins for other hospital and medical
(hospital and medical) |
0 |
0 |
0 |
| 15 |
Incentive pool, withhold adjustments and bonus
amounts (hospital and medical) |
0 |
0 |
0 |
| 16 |
Subtotal (hospital and medical) |
1,985,238 |
114,050,176 |
128,223,774 |
| 17 |
Net reinsurance recoveries (less) |
0 |
0 |
232,111 |
| 18 |
Total hospital and medical (less) |
1,985,238 |
114,050,176 |
127,991,663 |
| 19 |
Non-health claims (net) (less) |
0 |
0 |
0 |
| 20 |
Claims adjustment expenses, including $844830 cost
containment expenses (less) |
0 |
2,281,004 |
2,564,475 |
| 21 |
General administrative expenses (less) |
0 |
13,720,915 |
16,479,229 |
| 22 |
Increase in reserves for life and accident and
health contracts (including $0 increase in reserves for life only)
(less) |
0 |
124,624 |
552,825 |
| 23 |
Total underwriting deductions |
1,985,238 |
130,176,719 |
147,588,192 |
| 24 |
Net underwriting gain or (loss) |
|
3,029,453 |
4,729,578 |
| 25 |
Net investment income earned |
0 |
1,482,247 |
2,331,384 |
| 26 |
Net realized capital gains or (losses) less capital
gains tax of $-293293 |
0 |
-317,936 |
-910,129 |
| 27 |
Net investment gains or (losses) |
0 |
1,164,311 |
1,421,255 |
| 28 |
Net gain or (loss) from agents' or premium balances
charged off [(amount recovered $0 (amount charged off $0] |
0 |
0 |
0 |
| 29 |
Aggregate write-ins for other income or expenses |
0 |
0 |
0 |
| 30 |
Net income or (loss), after capital gains tax and
before all other federal income taxes |
|
4,193,764 |
6,150,833 |
| 31 |
Federal and foreign income taxes incurred |
|
301,805 |
-2,189,778 |
| 32 |
Net income (loss) |
|
3,891,959 |
8,340,611 |
|
Details of Write-Ins |
| 0699 |
|
|
0 |
0 |
| 0799 |
|
|
0 |
0 |
| 1499 |
|
0 |
0 |
0 |
| 2999 |
|
0 |
0 |
0 |
2009 STATEMENT OF REVENUE AND EXPENSES (Continued) - 005
95517 -
Aetna Health Inc ME Corp |
|
Line |
Current Year |
Prior Year |
| 33 |
Capital and surplus prior reporting year |
20,550,906 |
30,504,996 |
| 34 |
Net income or (loss) from Line 32 |
3,891,959 |
8,340,611 |
| 35 |
Change in valuation basis of aggregate policy and
claim reserves |
0 |
0 |
| 36 |
Change in net unrealized capital gains (losses) less
capital gains tax of $0 |
0 |
0 |
| 37 |
Change in net unrealized foreign exchange capital
gain or (loss) |
0 |
0 |
| 38 |
Change in net deferred income tax |
-695,500 |
-530,482 |
| 39 |
Change in nonadmitted assets |
496,384 |
248,366 |
| 40 |
Change in unauthorized reinsurance |
0 |
0 |
| 41 |
Change in treasury stock |
0 |
0 |
| 42 |
Change in surplus notes |
0 |
0 |
| 43 |
Cumulative effect of changes in accounting
principles |
0 |
0 |
| 44.1 |
Paid in (capital changes) |
0 |
0 |
| 44.2 |
Transferred from surplus (stock dividend) (capital
changes) |
0 |
0 |
| 44.3 |
Transferred to surplus (capital changes) |
0 |
0 |
| 45.1 |
Paid in (surplus adjustments) |
0 |
0 |
| 45.2 |
Transferred to capital (stock dividend) (surplus
adjustments) |
0 |
0 |
| 45.3 |
Transferred from capital (surplus adjustments) |
0 |
0 |
| 46 |
Dividends to stockholders |
-6,200,000 |
-18,400,000 |
| 47 |
Aggregate write-ins for gains or (losses) in
surplus |
1,332,388 |
387,415 |
| 48 |
Net change in capital and surplus |
-1,174,769 |
-9,954,090 |
| 49 |
Capital and surplus end of reporting year |
19,376,137 |
20,550,906 |
|
Details of Write-Ins |
| 4701 |
Additional Deferred Tax Asset Admitted Amount |
1,332,388 |
0 |
| 4702 |
Correction of Error - Current Federal Taxes |
0 |
387,415 |
| 4799 |
|
1,332,388 |
387,415 |
|
|
