ANNUAL STATEMENT OF THE BLUE CROSS & BLUE SHIELD OF RHODE ISLAND

Transcription

1 ANNUAL STATEMENT OF THE of in the state of PROVIDENCE COUNTY RHODE ISLAND TO THE Insurance Department OF THE FOR THE YEAR ENDED December 31, 2015 HEALTH 2015

2 ANNUAL STATEMENT For the Year Ended December 31, 2015 OF THE CONDITION AND AFFAIRS OF THE NAIC Group Code NAIC Company Code Employer's ID Number (Current Period) (Prior Period) Organized under the Laws of RHODE ISLAND, State of Domicile or Port of Entry RHODE ISLAND Country of Domicile USA Licensed as business type: Life, Accident & Health [ ] Property/Casualty [ ] Hospital, Medical & Dental Service or Indemnity [ X ] Dental Service Corporation [ ] Vision Service Corporation [ ] Health Maintenance Organization [ ] Other [ ] Is HMO Federally Qualified? Yes [ ] No [ ] Incorporated/Organized February 27, 1939 Commenced Business September 1, 1939 Statutory Home Office 500 EXCHANGE STREET, PROVIDENCE, RI, US (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office 500 EXCHANGE STREET (Street and Number) PROVIDENCE, RI, US (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address 500 EXCHANGE STREET, PROVIDENCE, RI, US (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records 500 EXCHANGE STREET PROVIDENCE, RI, US (Street and Number) (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Web Site Address Statutory Statement Contact MARK C. STEWART (Name) (Area Code) (Telephone Number) (Extension) MARK.STEWART@BCBSRI.ORG ( Address) (Fax Number) OFFICERS Name Title 1. PETER ANDRUSZKIEWICZ PRESIDENT & CEO 2. MICHELE B. LEDERBERG EVP. & GEN. COUNSEL 3. MICHAEL W. HUDSON EXECUTIVE VICE PRESIDENT & CFO VICE-PRESIDENTS Name Title Name Title CHRISTOPHER G. BUSH VP - UNDERWRITING MATTHEW COLLINS M.D. # VP - CLINICAL INTEGRATION DEREK COSTA # VP - CHIEF INFORMATION OFFICER MELISSA CUMMINGS SVP - CHIEF CUSTOMER OFFICER KATHERINE DALLOW M.D. # VP - CLINICAL AFFAIRS JEREMY DUNCAN VP - COMMUNICATIONS ERIK HELMS VP - PROV NET & MED ECONOMICS MARC HUDAK VP - CARE INNOVAT. & INTEGRATION JEFFREY J. KOLARIK # VP - OPERATIONS RICHARD H. KRUPSKI VP - EMPLOYER SEGMENT AUGUSTINE A. MANOCCHIA M.D. SVP - CHIEF MEDICAL OFFICER COREY R. MCCARTY VP - CONSUMER SEGMENT MONICA A. NERONHA VP - LEGAL SERVICES BRIAN M. O'MALLEY VP - FINANCE VISAEL RODRIGUEZ VP - CHIEF DIVERSITY OFFICER MARK C. STEWART # SVP - ASSOCIATE CFO MARK D. WAGGONER SVP - CARE INTEGRATION & MGMT DIRECTORS OR TRUSTEES DENISE A. BARGE MICHAEL DICHIRO SCOTT DUHAMEL # SCOTT GUNN JAMES A. HARRINGTON PETER C. HAYES DONNA HUNTLEY-NEWBY # ELIZABETH B. LANGE M.D. JOHN C. LANGENUS WARREN E. LICHT M.D. JOHN P. MAGUIRE PATRICIA MORAN # ROBERT G. NORTON DEBRA PAUL # PAUL PORTER M.D. PETER QUATTROMANI # MERRILL SHERMAN RANDY A. WYROFSKY State of.. RHODE..... ISLAND County of.. PROVIDENCE ss The officers of this reporting entity being duly sworn, each depose and say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or claims thereon, except as herein stated, and that this statement, together with related exhibits, schedules and explanations therein contained, annexed or referred to, is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of its income and deductions therefrom for the period ended, and have been completed in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2) that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be requested by various regulators in lieu of or in addition to the enclosed statement. (Signature) (Signature) (Signature) PETER ANDRUSZKIEWICZ MICHELE B. LEDERBERG MICHAEL W. HUDSON (Printed Name) (Printed Name) (Printed Name) PRESIDENT & CEO EVP. & GEN. COUNSEL EXECUTIVE VICE PRESIDENT & CFO (Title) (Title) (Title) Subscribed and sworn to (or affirmed) before me this on this day of, 2016, by a. Is this an original filing? [ X ] Yes [ ] No b. If no: 1. State the amendment number 2. Date filed 3. Number of pages attached

3 ASSETS Current Year Prior Year Net Admitted Nonadmitted Assets Net Admitted Assets Assets (Cols. 1-2) Assets 1. Bonds (Schedule D) 319,019, ,019, ,711, Stocks (Schedule D): 2.1 Preferred stocks 2.2 Common stocks 35,387,361 35,387,361 68,115, Mortgage loans on real estate (Schedule B): 3.1 First liens 3.2 Other than first liens 4. Real estate (Schedule A): 4.1 Properties occupied by the company (less $... 73,274, encumbrances) 34,991,884 34,991,884 34,089, Properties held for the production of income (less $ encumbrances) 4.3 Properties held for sale (less $ encumbrances) 5. Cash ($...(1,031,483) , Schedule E - Part 1), cash equivalents ($ , , Schedule E - Part 2), and short-term investments ($.... 5,626, , Schedule DA) 4,634,263 4,634,263 7,238, Contract loans (including $ premium notes) 7. Derivatives (Schedule DB) 8. Other invested assets (Schedule BA) 41,579,161 41,579,161 85,786, Receivables for securities Securities lending reinvested collateral assets (Schedule DL) 11. Aggregate write-ins for invested assets Subtotals, cash and invested assets (Lines 1 to 11) 435,611, ,611, ,941, Title plants less $ charged off (for Title insurers only) 14. Investment income due and accrued 1,529,790 1,529,790 1,333, Premiums and considerations: 15.1 Uncollected premiums and agents' balances in the course of collection 52,272,688 2,452,655 49,820,033 56,749, Deferred premiums, agents' balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) 15.3 Accrued retrospective premiums ($ ) and contracts subject to redetermination ($ ) 13,601, ,725 13,273, Reinsurance: 16.1 Amounts recoverable from reinsurers 12,666,138 12,666,138 19,602, Funds held by or deposited with reinsured companies 16.3 Other amounts receivable under reinsurance contracts 17. Amounts receivable relating to uninsured plans 40,097,248 40,097,248 39,035, Current federal and foreign income tax recoverable and interest thereon 18.2 Net deferred tax asset 29,515,902 15,429,541 14,086, Guaranty funds receivable or on deposit 20. Electronic data processing equipment and software 39,893,322 37,127,752 2,765,570 2,132, Furniture and equipment, including health care delivery assets ($ ) 4,957,242 4,957, Net adjustment in assets and liabilities due to foreign exchange rates 23. Receivables from parent, subsidiaries and affiliates 24. Health care ($... 25,737, ) and other amounts receivable 27,770,640 2,033,468 25,737,172 16,357, Aggregate write-ins for other-than-invested assets ,726,842 11,023,034 29,703,808 25,459, Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 698,643,223 73,351, ,291, ,611, From Separate Accounts, Segregated Accounts and Protected Cell Accounts Total (Lines 26 and 27) 698,643,223 73,351, ,291, ,611, DETAILS OF WRITE-IN LINES NONE Summary of remaining write-ins for Line 11 from overflow page Totals (Lines 1101 through 1103 plus 1198) (Line 11 above) OTHER RECEIVABLES 23,209,523 23,209,523 17,080, PREPAID EXPENSES 10,548,619 10,548, FEP UNPAID CLAIMS 6,256,768 6,256,768 8,133, Summary of remaining write-ins for Line 25 from overflow page , , , , Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) 40,726,842 11,023,034 29,703,808 25,459,

4 Annual Statement for the year 2015 of the LIABILITIES, CAPITAL AND SURPLUS Current Year Prior Year Covered Uncovered Total Total Claims unpaid (less $ reinsurance ceded) 128,122, ,122, ,163, Accrued medical incentive pool and bonus amounts 14,839,049 14,839,049 12,502, Unpaid claims adjustment expenses 21,861,146 21,861,146 24,857, Aggregate health policy reserves, including the liability of $ for medical loss ratio rebate per the Public Health Services Act 21,437,726 21,437,726 20,813, Aggregate life policy reserves 6. Property/casualty unearned premium reserves 7. Aggregate health claim reserves 3,603,000 3,603,000 3,711, Premiums received in advance 16,998,131 16,998,131 25,785, General expenses due or accrued 37,089,968 37,089,968 42,171, Current federal and foreign income tax payable and interest thereon 106, (including $ on realized gains (losses)) 380, , , Net deferred tax liability 11. Ceded reinsurance premiums payable 194, , , Amounts withheld or retained for the account of others 507, , , Remittances and items not allocated 1,744,365 1,744, , ,000, Borrowed money (including $ current) and interest 95, , thereon $ (including $ current) 40,095,650 40,095,650 50,052, Amounts due to parent, subsidiaries and affiliates 16. Derivatives 17. Payable for securities 89,477 89, Payable for securities lending Funds held under reinsurance treaties (with $ authorized reinsurers, $ unauthorized reinsurers and $ certified reinsurers) Reinsurance in unauthorized and certified $ ( ) companies 21. Net adjustments in assets and liabilities due to foreign exchange rates 22. Liability for amounts held under uninsured plans 33,072,432 33,072,432 25,632, ,534, Aggregate write-ins for other liabilities (including $ current) 9,938,420 9,938,420 14,789, Total liabilities (Lines 1 to 23) 329,974, ,974, ,566, Aggregate write-ins for special surplus funds X X X X X X 29,500,000 29,900, Common capital stock X X X X X X 27. Preferred capital stock X X X X X X 28. Gross paid in and contributed surplus X X X X X X 29. Surplus notes X X X X X X 30. Aggregate write-ins for other than special surplus funds X X X X X X 31. Unassigned funds (surplus) X X X X X X 265,817, ,145, Less treasury stock, at cost: shares common (value included in Line 26 $ ) X X X X X X shares preferred (value included in Line 27 $ ) X X X X X X 33. Total capital and surplus (Lines 25 to 31 minus Line 32) X X X X X X 295,317, ,045, Total liabilities, capital and surplus (Lines 24 and 33) X X X X X X 625,291, ,611,830 DETAILS OF WRITE-IN LINES UNFUNDED ACCUMULATED BENEFIT OBLIGATION 4,599,580 4,599,580 3,400, OTHER ACCOUNTS PAYABLE 3,326,226 3,326,226 6,641, ACCRUED CAPITAL EXPENSES 1,970,092 1,970,092 4,582, Summary of remaining write-ins for Line 23 from overflow page 42,522 42, , Totals (Lines 2301 through 2303 plus 2398) (Line 23 above) 9,938,420 9,938,420 14,789, PPACA HEALTH INSURER FEE 2015 X X X X X X 29,500,000 29,900, X X X X X X X X X X X X Summary of remaining write-ins for Line 25 from overflow page X X X X X X Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) X X X X X X 29,500,000 29,900, X X X X X X X X X X X X X X X X X X Summary of remaining write-ins for Line 30 from overflow page X X X X X X Totals (Lines 3001 through 3003 plus 3098) (Line 30 above) X X X X X X NONE

5 STATEMENT OF REVENUE AND EXPENSES Current Year Prior Year Uncovered Total Total 1. Member Months X X X 4,219,900 4,663, Net premium income (including $ non-health premium income) X X X 1,664,052,254 1,644,025, Change in unearned premium reserves and reserve for rate credits X X X (2,733,445) (3,486,234) 4. Fee-for-service (net of $ medical expenses) X X X 5. Risk revenue X X X 6. Aggregate write-ins for other health care related revenues X X X 7. Aggregate write-ins for other non-health revenues X X X 8. Total revenues (Lines 2 to 7) X X X 1,661,318,809 1,640,538,775 Hospital and Medical: 9. Hospital/medical benefits 950,509, ,630, Other professional services 23,015,825 24,055, Outside referrals 12. Emergency room and out-of-area 137,913, ,776, Prescription drugs 238,123, ,748, Aggregate write-ins for other hospital and medical 44,823,600 45,718, Incentive pool, withhold adjustments and bonus amounts 10,630,179 14,464, Subtotal (Lines 9 to 15) 1,405,015,977 1,423,392,577 Less: 17. Net reinsurance recoveries 16,585,067 19,368, Total hospital and medical (Lines 16 minus 17) 1,388,430,910 1,404,023, Non-health claims (net) Claims adjustment expenses, including $... 24,235, cost containment expenses 75,948,457 69,757, General administrative expenses 175,298, ,260, Increase in reserves for life and accident and health contracts (including $ increase in reserves for life only) Total underwriting deductions (Lines 18 through 22) 1,639,677,521 1,651,041, Net underwriting gain or (loss) (Lines 8 minus 23) X X X 21,641,288 (10,502,677) 25. Net investment income earned (Exhibit of Net Investment Income, Line 17) 2,316,909 1,896, Net realized capital gains (losses) less capital gains tax of $ ,243,719 12,621, Net investment gains (losses) (Lines 25 plus 26) 10,560,628 14,518, Net gain or (loss) from agents' or premium balances charged off [ (amount recovered $ ) (amount charged off $ ) ] 29. Aggregate write-ins for other income or expenses (157,234,781) (3,789,752) 30. Net income or (loss) after capital gains tax and before all other federal income taxes (Lines 24 plus 27 plus 28 plus 29) X X X (125,032,865) 225, Federal and foreign income taxes incurred X X X 914, , Net income (loss) (Lines 30 minus 31) X X X (125,947,322) 113,234 DETAILS OF WRITE-IN LINES X X X NONE X X X X X X Summary of remaining write-ins for Line 06 from overflow page X X X Totals (Lines 0601 through 0603 plus 0698) (Line 06 above) X X X X X X NONE X X X X X X Summary of remaining write-ins for Line 07 from overflow page X X X Totals (Lines 0701 through 0703 plus 0798) (Line 07 above) X X X MENTAL HEALTH 44,823,600 45,718, Summary of remaining write-ins for Line 14 from overflow page Totals (Lines 1401 through 1403 plus 1498) (Line 14 above) 44,823,600 45,718, GOOD HEALTH BENEFIT REVENUE 2,806,622 2,861, OTHER INCOME (NOTE RECEIVABLE) 6,167 6, PREMIUM ASSISTANCE PROGRAM 1,522 (43,641) Summary of remaining write-ins for Line 29 from overflow page (160,049,092) (6,613,280) Totals (Lines 2901 through 2903 plus 2998) (Line 29 above) (157,234,781) (3,789,752) 4

6 STATEMENT OF REVENUE AND EXPENSES (Continued) 1 2 Current Year Prior Year CAPITAL & SURPLUS ACCOUNT 33. Capital and surplus prior reporting year 264,045, ,601, Net income or (loss) from Line 32 (125,947,322) 113, Change in valuation basis of aggregate policy and claim reserves 36. Change in net unrealized capital gains (losses) less capital gains tax of $ (11,787,921) (8,168,033) 37. Change in net unrealized foreign exchange capital gain or (loss) 38. Change in net deferred income tax 29,515, Change in nonadmitted assets 158,376,531 (13,179,492) 40. Change in unauthorized and certified reinsurance 41. Change in treasury stock 42. Change in surplus notes 43. Cumulative effect of changes in accounting principles 44. Capital Changes: 44.1 Paid in 44.2 Transferred from surplus (Stock Dividend) 44.3 Transferred to surplus 45. Surplus adjustments: 45.1 Paid in 45.2 Transferred to capital (Stock Dividend) 45.3 Transferred from capital 46. Dividends to stockholders Aggregate write-ins for gains or (losses) in surplus (18,885,068) (2,321,472) Net change in capital and surplus (Lines 34 to 47) 31,272,122 (23,555,763) Capital and surplus end of reporting year (Line 33 plus 48) 295,317, ,045,437 DETAILS OF WRITE-IN LINES QUALIFIED PENSION EXPENSE TERMINATION SETTLEMENT 2,650, NON-QUALIFIED PENSION PLAN 61, CHANGE IN UNRECOGNIZED PRIOR SERVICE COST (2,012,482) Summary of remaining write-ins for Line 47 from overflow page (21,597,183) (308,990) Totals (Lines 4701 through 4703 plus 4798) (Line 47 above) (18,885,068) (2,321,472) 5

7 CASH FLOW 1 2 Cash from Operations Current Year Prior Year 1. Premiums collected net of reinsurance ,646,289, ,630,249, Net investment income ,623, ,938, Miscellaneous income (3,265,193) (3,725,272) 4. Total (Lines 1 through 3) ,646,648, ,630,462, Benefit and loss related payments ,390,027, ,478,971, Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts Commissions, expenses paid and aggregate write-ins for deductions ,583, ,639, Dividends paid to policyholders Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) ,819 (73,250) 10. Total (Lines 5 through 9) ,624,336,500 1,644,538, Net cash from operations (Line 4 minus Line 10) 22,311,824 (14,075,724) Cash from Investments 12. Proceeds from investments sold, matured or repaid: 12.1 Bonds.. 65,981, ,559, Stocks.. 44,449, ,016, Mortgage loans Real estate Other invested assets ,957, ,579, Net gains or (losses) on cash, cash equivalents and short-term investments Miscellaneous proceeds (3,106,550) 12.8 Total investment proceeds (Lines 12.1 to 12.7) ,387, ,048, Cost of investments acquired (long-term only): 13.1 Bonds. 129,002, ,485, Stocks.. 11,945, ,133, Mortgage loans Real estate ,408, , Other invested assets ,860, ,474, Miscellaneous applications ,850, Total investments acquired (Lines 13.1 to 13.6) ,216, ,370, Net increase (decrease) in contract loans and premium notes Net cash from investments (Line 12.8 minus Line 13.7 minus Line 14) 8,171,298 (27,321,764) Cash from Financing and Miscellaneous Sources 16. Cash provided (applied): 16.1 Surplus notes, capital notes Capital and paid in surplus, less treasury stock Borrowed funds (9,956,500) ,029, Net deposits on deposit-type contracts and other insurance liabilities Dividends to stockholders Other cash provided (applied) (23,130,473) (3,214,866) 17. Net cash from financing and miscellaneous sources (Lines 16.1 to 16.4 minus Line 16.5 plus Line 16.6) (33,086,973) 11,814, RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) (2,603,851) (29,583,158) Cash, cash equivalents and short-term investments: 19.1 Beginning of year ,238,114 36,821, End of year (Line 18 plus Line 19.1) 4,634,263 7,238,114 Note: Supplemental disclosures of cash flow information for non-cash transactions:

8 Annual Statement for the year 2015 of the ANALYSIS OF OPERATIONS BY LINES OF BUSINESS Federal Comprehensive Employees Title Title (Hospital & Medicare Dental Vision Health XVIII XIX Other Other Total Medical) Supplement Only Only Benefit Plan Medicare Medicaid Health Non-Health 1. Net premium income 1,664,052, ,905,729 56,054,707 29,414, ,597, ,426,257 23,652, Change in unearned premium reserves and reserve for rate credit (2,733,445) (2,733,445) Fee-for-service (net of $ medical expenses) X X X 4. Risk revenue X X X 5. Aggregate write-ins for other health care related revenues X X X 6. Aggregate write-ins for other non-health care related revenues X X X X X X X X X X X X X X X X X X X X X X X X 7. Total revenues (Lines 1 to 6) 1,661,318, ,905,729 56,054,707 29,414, ,864, ,426,257 23,652, Hospital/medical benefits 950,509, ,625,680 42,584,516 75,792, ,085,229 1,421,773 X X X 9. Other professional services 23,015,825 23,015,825 X X X 10. Outside referrals X X X 11. Emergency room and out-of-area 137,913,199 89,783,412 48,129,787 X X X 12. Prescription drugs 238,123, ,530,265 23,748,646 48,193,923 12,650,341 X X X 13. Aggregate write-ins for other hospital and medical 44,823,600 36,548,837 8,274,763 X X X 14. Incentive pool, withhold adjustments and bonus amounts 10,630,179 5,982,860 4,647,319 X X X 15. Subtotal (Lines 8 to 14) 1,405,015, ,471,054 42,584,516 23,015,825 99,541, ,331,021 14,072,114 X X X 16. Net reinsurance recoveries 16,585,067 16,585,067 X X X 17. Total hospital and medical (Lines 15 minus 16) 1,388,430, ,885,987 42,584,516 23,015,825 99,541, ,331,021 14,072,114 X X X 18. Non-health claims (net) X X X X X X X X X X X X X X X X X X X X X X X X ,235, Claims adjustment expenses including $ cost containment expenses 75,948,457 43,285,183 2,742,537 2,928,369 3,915,111 22,255, , General administrative expenses 175,298, ,050,983 4,869,277 5,742,551 7,305,672 49,576,446 1,753, Increase in reserves for accident and health contracts X X X 22. Increase in reserves for life contracts X X X X X X X X X X X X X X X X X X X X X X X X 23. Total underwriting deductions (Lines 17 to 22) 1,639,677, ,222,153 50,196,330 31,686, ,762, ,162,832 16,647, Net underwriting gain or (loss) (Line 7 minus Line 23) 21,641,288 26,683,576 5,858,377 (2,271,788) 1,102,143 (16,736,575) 7,005,555 DETAILS OF WRITE-IN LINES X X X X X X X X X Summary of remaining write-ins for Line 05 from overflow page X X X Totals (Lines 0501 through 0503 plus 0598) (Line 05 above) X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Summary of remaining write-ins for Line 06 from overflow page X X X X X X X X X X X X X X X X X X X X X X X X Totals (Lines 0601 through 0603 plus 0698) (Line 06 above) X X X X X X X X X X X X X X X X X X X X X X X X MENTAL HEALTH 44,823,600 36,548,837 8,274,763 X X X X X X X X X Summary of remaining write-ins for Line 13 from overflow page X X X Totals (Lines 1301 through 1303 plus 1398) (Line 13 above) 44,823,600 36,548,837 8,274,763 X X X NONE NONE

9 UNDERWRITING AND INVESTMENT EXHIBIT PART 1 PREMIUMS Line of Net Premium Income Business Direct Business Reinsurance Assumed Reinsurance Ceded (Cols ) 1. Comprehensive (hospital and medical) 895,580, , ,905, Medicare Supplement 56,054,707 56,054, Dental only 29,414,957 29,414, Vision only 5. Federal Employees Health Benefits Plan 111,864, ,864, Title XVIII Medicare 545,426, ,426, Title XIX Medicaid 8. Other health 24,523, ,138 23,652, Health subtotal (Lines 1 through 8) 1,662,864,989 1,546,179 1,661,318, Life 11. Property/casualty Totals (Lines 9 to 11) 1,662,864,989 1,546,179 1,661,318,810 8

10 Annual Statement for the year 2015 of the UNDERWRITING AND INVESTMENT EXHIBIT PART 2 CLAIMS INCURRED DURING THE YEAR Federal Comprehensive Employees Title Title (Hospital & Medicare Dental Vision Health XVIII XIX Other Other Total Medical) Supplement Only Only Benefits Plan Medicare Medicaid Health Non-Health 1. Payments during the year: 1.1 Direct 1,405,878, ,888,743 43,677,507 22,620, ,413, ,141,040 14,137, Reinsurance assumed 1.3 Reinsurance ceded 23,394,917 23,394, Net 1,382,484, ,493,826 43,677,507 22,620, ,413, ,141,040 14,137, Paid medical incentive pools and bonuses 8,293,808 7,132,675 1,161, Claim liability December 31, current year from Part 2A: 3.1 Direct 128,122,614 66,468,631 5,548,000 1,837,000 7,419,301 45,544,244 1,305, Reinsurance assumed 3.3 Reinsurance ceded 3.4 Net 128,122,614 66,468,631 5,548,000 1,837,000 7,419,301 45,544,244 1,305, Claim reserve December 31, current year from Part 2D: 4.1 Direct 3,603,000 3,603, Reinsurance assumed 4.3 Reinsurance ceded 4.4 Net 3,603,000 3,603, Accrued medical incentive pools and bonuses, current year 14,839,049 9,185,089 5,653, Net healthcare receivables (a) 10,344,278 11,912,262 (12,009) (1,555,975) 7. Amounts recoverable from reinsurers December 31, current year 12,558,782 12,558, Claim liability December 31, prior year from Part 2A: 8.1 Direct 129,163,491 69,884,852 6,653,000 1,442,000 9,290,938 40,521,622 1,371, Reinsurance assumed 8.3 Reinsurance ceded 8.4 Net 129,163,491 69,884,852 6,653,000 1,442,000 9,290,938 40,521,622 1,371, Claim reserve December 31, prior year from Part 2D: 9.1 Direct 3,711,000 3,711, Reinsurance assumed 9.3 Reinsurance ceded 9.4 Net 3,711,000 3,711, Accrued medical incentive pools and bonuses, prior year 12,502,678 8,298,969 4,203, Amounts recoverable from reinsurers December 31, prior year 19,368,632 19,368, Incurred benefits: 12.1 Direct 1,394,385, ,452,260 42,584,516 23,015,825 99,541, ,719,637 14,072, Reinsurance assumed 12.3 Reinsurance ceded 16,585,067 16,585, Net 1,377,800, ,867,193 42,584,516 23,015,825 99,541, ,719,637 14,072, Incurred medical incentive pools and bonuses 10,630,179 8,018,795 2,611,384 (a) Excludes $ loans or advances to providers not yet expensed

11 UNDERWRITING AND INVESTMENT EXHIBIT PART 2A CLAIMS LIABILITY END OF CURRENT YEAR Federal Comprehensive Employees Title Title (Hospital & Medicare Dental Vision Health XVIII XIX Other Other Total Medical) Supplement Only Only Benefits Plan Medicare Medicaid Health Non-Health Reported in Process of Adjustment: 1.1 Direct 51,537,046 30,117, , ,694 1,764,792 17,026,248 1,305, Reinsurance assumed 1.3 Reinsurance ceded 1.4 Net 51,537,046 30,117, , ,694 1,764,792 17,026,248 1,305, Incurred but Unreported: 2.1 Direct 76,585,568 36,351,183 5,008,574 1,053,306 5,654,509 28,517, Reinsurance assumed 2.3 Reinsurance ceded 2.4 Net 76,585,568 36,351,183 5,008,574 1,053,306 5,654,509 28,517, Amounts Withheld from Paid Claims and Capitations: 3.1 Direct 3.2 Reinsurance assumed 3.3 Reinsurance ceded 3.4 Net 4. TOTALS: Direct 128,122,614 66,468,631 5,548,000 1,837,000 7,419,301 45,544,244 1,305, Reinsurance assumed 4.3 Reinsurance ceded Net 128,122,614 66,468,631 5,548,000 1,837,000 7,419,301 45,544,244 1,305,438

12 UNDERWRITING AND INVESTMENT EXHIBIT PART 2B ANALYSIS OF CLAIMS UNPAID PRIOR YEAR-NET OF REINSURANCE Claim Reserve and Claim 5 6 Claims Liability December 31 Paid During the Year of Current Year Claims Estimated Claim Incurred Reserve and On Claims Incurred On Claims Incurred On Claims Unpaid On Claims Incurred in Claim Liability Prior to January 1 During the December 31 During the Prior Years December 31 Line of Business of Current Year Year of Prior Year Year (Columns 1 + 3) of Prior Year Comprehensive (hospital and medical) 55,971, ,335, ,071 69,835,560 56,207,451 73,595, Medicare Supplement 4,854,172 38,823,335 (3,714) 5,551,714 4,850,458 6,653, Dental only 1,542,102 21,078,723 5,815 1,831,185 1,547,917 1,442, Vision only 5. Federal Employees Health Benefits Plan 8,342,627 93,070,457 79,724 7,339,577 8,422,351 9,290, Title XVIII Medicare 33,149, ,991,263 1,104,394 44,439,850 34,254,171 40,521, Title XIX Medicaid 8. Other health 1,535,625 12,602, ,417 1,183,021 1,658,042 1,371, Health subtotal (Lines 1 to 8) 105,395,683 1,283,901,202 1,544, ,180, ,940, ,874, Health care receivables (a) 5,141,881 22,628,758 5,141,881 17,426, Other non-health Medical incentive pools and bonus amounts 8,293,808 1,361,183 13,477,866 9,654,991 12,505, Totals (Lines ) 108,547,610 1,261,272,444 2,905, ,658, ,453, ,953,807 (a) Excludes $ loans or advances to providers not yet expensed.

13 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Hospital & Medical Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior 837, , , , , , , , , , X X X 768, , , , X X X X X X 749, , , X X X X X X X X X 711, , X X X X X X X X X X X X 711,761 Section B Incurred Health Claims 12.HM Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior 837, , , , , , , , , , X X X 768, , , , X X X X X X 749, , , X X X X X X X X X 711, , X X X X X X X X X X X X 789,826 Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent , , , , , , , , , , , , , ,293 21, , , , , ,761 21, , ,065 11, ,

14 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Medicare Supplement Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior 43,553 43,562 43,556 43,575 43, ,294 42,480 42,514 42,680 42, X X X 37,499 43,404 44,564 44, X X X X X X 37,601 43,900 43, X X X X X X X X X 38,898 43, X X X X X X X X X X X X 38,839 Section B Incurred Health Claims 12.MS Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior 43,553 43,562 43,556 43,575 43, ,294 42,480 42,514 42,680 42, X X X 37,499 43,404 44,564 44, X X X X X X 37,601 43,900 43, X X X X X X X X X 38,898 43, X X X X X X X X X X X X 44,391 Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent ,710 42,692 42, , ,964 44,568 44, , ,736 43,929 43, , ,334 43,692 1, , (4) 44, ,055 38,839 1, , , ,

15 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Dental Only Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior 26,583 22,786 22,785 22,785 22, ,387 22,751 22,753 22,753 22, X X X 21,354 23,401 23,401 23, X X X X X X 21,214 22,515 22, X X X X X X X X X 22,820 24, X X X X X X X X X X X X 21,079 Section B Incurred Health Claims 12.DO Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior 26,583 22,786 22,785 22,785 22, ,387 22,751 22,753 22,753 22, X X X 21,354 23,401 23,401 23, X X X X X X 21,214 22,515 22, X X X X X X X X X 22,820 24, X X X X X X X X X X X X 22,910 Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent ,947 22,753 22, , ,711 23,402 23, , ,887 22,517 22, , ,381 24, , , ,415 21, , , ,

16 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Vision Only Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior X X X X X X X X X NONE X X X X X X X X X X X X X X X X X X X X X Section B Incurred Health Claims 12.VO Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior NONE X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent NONE

17 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Fed Emp Health Benefits Plan Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior 94,835 94,731 94,590 94,582 94, ,814 86,710 86,777 86,841 86, X X X 85,195 93,826 93,875 93, X X X X X X 82,306 95,316 95, X X X X X X X X X 88,486 96, X X X X X X X X X X X X 93,070 Section B Incurred Health Claims 12.FE Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior 94,835 94,731 94,590 94,582 94, ,814 86,710 86,777 86,841 86, X X X 85,195 93,826 93,875 93, X X X X X X 82,306 95,316 95, X X X X X X X X X 88,486 96, X X X X X X X X X X X X 100,410 Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent ,949 86,844 86, , ,536 93,873 93, , ,717 95,435 95, , ,337 96,702 2, , , ,864 93,070 2, , ,340 1, ,

18 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Title XVIII - Medicare Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior 339, , , , , , , , , , X X X 327, , , , X X X X X X 307, , , X X X X X X X X X 423, , X X X X X X X X X X X X 453,479 Section B Incurred Health Claims 12.XV Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior 339, , , , , , , , , , X X X 327, , , , X X X X X X 307, , , X X X X X X X X X 423, , X X X X X X X X X X X X 503,167 Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent , , , , , , , , , , , , , ,158 13, , , , , ,479 13, , ,688 7, ,

19 UNDERWRITING AND INVESTMENT EXHIBIT PART 2C DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Title XIX - Medicaid Section A Paid Health Claims Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior 37,571 37,557 37,569 37,570 37, X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Section B Incurred Health Claims 12.XI Sum of Cumulative Net Amount Paid and Claim Liability, Claim Reserve and Medical Incentive Pool and Bonuses Outstanding at End of Year Year in Which Losses Were Incurred Prior 37,571 37,557 37,569 37,570 37, X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Section C Incurred Year Health Claims and Claims Adjustment Expense Ratio Total Claims Claim and Claim and Claims Years in which Claim Adjustment Unpaid Adjustment Premiums were Earned Adjustment Expense Claims Expense and Premiums Claims Expense (Col. 3 / 2) Payments (Col. 5 / 1) Claims Adjustment Incurred (Col. 9 / 1) Claims were Incurred Earned Payments Payments Percent (Col ) Percent Unpaid Expenses (Col ) Percent (228)