HEALTH ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 31, 2014 OF THE CONDITION AND AFFAIRS OF THE HealthSpring of Florida, Inc.

Transcription

1 HEALTH ANNUAL STATEMENT FOR THE YEAR ENDED DECEMBER 3, 04 OF THE CONDITION AND AFFAIRS OF THE HealthSpring of Florida, Inc. NAIC Group Code NAIC Company Code 53 Employer's ID Number (Current) (Prior) Organized under the Laws of Florida, State of Domicile or Port of Entry Florida Country of Domicile Licensed as business type: United States of America Health Maintenance Organization Is HMO Federally Qualified? Yes [ ] No [ X ] Incorporated/Organized 06//00 Commenced Business 08/0/00 Statutory Home Office 8600 NW 4st Street Suite 0, Doral, FL, US 3366 (Street and Number) (City or Town, State, Country and Zip Code) Main Administrative Office 8600 NW 4st Street Suite 0 (Street and Number) Doral, FL, US 3366, (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Mail Address 8600 NW 4st Street Suite 0, Doral, FL, US 3366 (Street and Number or P.O. Box) (City or Town, State, Country and Zip Code) Primary Location of Books and Records 8600 NW 4st Street Suite 0 (Street and Number) Doral, FL, US 3366, (City or Town, State, Country and Zip Code) (Area Code) (Telephone Number) Internet Website Address Statutory Statement Contact Mercedes Marill Kirkpatrick, (Name) (Area Code) (Telephone Number) mmarillk@healthspring.com, ( Address) (FAX Number) OFFICERS President and CEO, Chairman of the Board Albert Raphael Maury Chief Financial Officer Ryan Bruce McGroarty # Co-CEO Matthew Shawn Morris # Vice President and Secretary Gregory James Allen OTHER Henry Hernandez Vice President and COO Richard Alan Appel Compliance Officer David Bradley Holladay # President - Government Pharmacy Services Alina de los Angeles Campos Vega MD Medical Director David Lowell Terry Chief Actuary Robert Lambdin Dawson Vice President Maureen Hardiman Ryan Vice President and Assistant Treasurer Scott Ronald Lambert Vice President and Treasurer Jumana Nadeem Siddiqui Assistant Treasurer Kevin James Oleksak Assistant Secretary Rhiannon Ashley Bernier Assistant Secretary Anna Krishtul Assistant Secretary Sheffield Hoover Young Vice President DIRECTORS OR TRUSTEES Albert Raphael Maury Alina de los Angeles Campos Vega MD Mercedes Marill Kirkpatrick State of County of Florida Miami-Dade 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: () state law may differ; or, () 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. Albert Raphael Maury Ryan Bruce McGroarty # Gregory James Allen President and CEO Chief Financial Officer Vice President and Secretary a. Is this an original filing? Yes [ X ] No [ ] Subscribed and sworn to before me this b. If no, day of. State the amendment number. Date filed 3. Number of pages attached

2 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. ASSETS Assets Current Year Nonadmitted Assets 3 Net Admitted Assets (Cols. - ) Prior Year 4 Net Admitted Assets. Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks 3. Mortgage loans on real estate (Schedule B): 3. First liens 3. Other than first liens 4. Real estate (Schedule A): 4. Properties occupied by the company (less $ encumbrances) 4. Properties held for the production of income (less $ encumbrances) 4.3 Properties held for sale (less $ encumbrances) 5. Cash ($, Schedule E - Part ), cash equivalents ($, Schedule E - Part ) and short-term investments ($, Schedule DA) 6. Contract loans, (including $ premium notes) 7. Derivatives (Schedule DB) 8. Other invested assets (Schedule BA) 9. Receivables for securities 0. Securities lending reinvested collateral assets (Schedule DL). Aggregate write-ins for invested assets. Subtotals, cash and invested assets (Lines to ) 3. Title plants less $ charged off (for Title insurers only) 4. Investment income due and accrued 5. Premiums and considerations: 5. Uncollected premiums and agents' balances in the course of collection 5. Deferred premiums, agents' balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) 5.3 Accrued retrospective premiums 6. Reinsurance: 6. Amounts recoverable from reinsurers 6. Funds held by or deposited with reinsured companies 6.3 Other amounts receivable under reinsurance contracts 7. Amounts receivable relating to uninsured plans 8. Current federal and foreign income tax recoverable and interest thereon 8. Net deferred tax asset 9. Guaranty funds receivable or on deposit 0. Electronic data processing equipment and software. Furniture and equipment, including health care delivery assets ($ ). Net adjustment in assets and liabilities due to foreign exchange rates 3. Receivables from parent, subsidiaries and affiliates 4. Health care ($ ) and other amounts receivable 5. Aggregate write-ins for other than invested assets 6. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines to 5) 7. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 8. Total (Lines 6 and 7) DETAILS OF WRITE-INS 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 03 plus 98)(Line above) 50.!"#$ 50. %"$&' Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 503 plus 598)(Line 5 above)

3 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. LIABILITIES, CAPITAL AND SURPLUS Current Year 3 Prior Year 4 Covered Uncovered Total Total. Claims unpaid (less $ reinsurance ceded). Accrued medical incentive pool and bonus amounts 3. Unpaid claims adjustment expenses 4. Aggregate health policy reserves, including the liability of $ for medical loss ratio rebate per the Public Health Service Act 5. Aggregate life policy reserves 6. Property/casualty unearned premium reserves 7. Aggregate health claim reserves 8. Premiums received in advance 9. General expenses due or accrued 0. Current federal and foreign income tax payable and interest thereon (including $ on realized capital gains (losses)) 0. Net deferred tax liability. Ceded reinsurance premiums payable. Amounts withheld or retained for the account of others 3. Remittances and items not allocated 4. Borrowed money (including $ current) and interest thereon $ (including $ current) 5. Amounts due to parent, subsidiaries and affiliates 6. Derivatives 7. Payable for securities 8. Payable for securities lending 9. Funds held under reinsurance treaties (with $ authorized reinsurers, $ unauthorized reinsurers and $ certified reinsurers) 0. Reinsurance in unauthorized and certified ($ companies. Net adjustments in assets and liabilities due to foreign exchange rates. Liability for amounts held under uninsured plans 3. Aggregate write-ins for other liabilities (including $ current) 4. Total liabilities (Lines to 3) 5. Aggregate write-ins for special surplus funds XXX XXX 6. Common capital stock XXX XXX 7. Preferred capital stock XXX XXX 8. Gross paid in and contributed surplus XXX XXX 9. Surplus notes XXX XXX 30. Aggregate write-ins for other than special surplus funds XXX XXX 3. Unassigned funds (surplus) XXX XXX 3. Less treasury stock, at cost: 3. shares common (value included in Line 6 $ ) XXX XXX 3. shares preferred (value included in Line 7 $ ) XXX XXX 33. Total capital and surplus (Lines 5 to 3 minus Line 3) XXX XXX 34. Total liabilities, capital and surplus (Lines 4 and 33) XXX XXX DETAILS OF WRITE-INS Summary of remaining write-ins for Line 3 from overflow page 399. Totals (Lines 30 thru 303 plus 398)(Line 3 above) 50.!!"# XXX XXX 50. XXX XXX 503. XXX XXX 598. Summary of remaining write-ins for Line 5 from overflow page XXX XXX 599. Totals (Lines 50 thru 503 plus 598)(Line 5 above) XXX XXX 300. XXX XXX 300. XXX XXX XXX XXX Summary of remaining write-ins for Line 30 from overflow page XXX XXX Totals (Lines 300 thru 3003 plus 3098)(Line 30 above) XXX XXX 3

4 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. STATEMENT OF REVENUE AND EXPENSES Current Year Uncovered Total Prior Year 3 Total. Member Months XXX. Net premium income ( including $ non-health premium income) XXX 3. Change in unearned premium reserves and reserve for rate credits XXX 4. Fee-for-service (net of $ medical expenses) XXX 5. Risk revenue XXX 6. Aggregate write-ins for other health care related revenues XXX 7. Aggregate write-ins for other non-health revenues XXX 8. Total revenues (Lines to 7) XXX Hospital and Medical: 9. Hospital/medical benefits 0. Other professional services. Outside referrals. Emergency room and out-of-area 3. Prescription drugs 4. Aggregate write-ins for other hospital and medical 5. Incentive pool, withhold adjustments and bonus amounts 6. Subtotal (Lines 9 to 5) Less: 7. Net reinsurance recoveries 8. Total hospital and medical (Lines 6 minus 7) 9. Non-health claims (net) 0. Claims adjustment expenses, including $ cost containment expenses. General administrative expenses. Increase in reserves for life and accident and health contracts (including $ increase in reserves for life only) 3. Total underwriting deductions (Lines 8 through ) 4. Net underwriting gain or (loss) (Lines 8 minus 3) XXX 5. Net investment income earned (Exhibit of Net Investment Income, Line 7) 6. Net realized capital gains (losses) less capital gains tax of $ 7. Net investment gains (losses) (Lines 5 plus 6) 8. Net gain or (loss) from agents or premium balances charged off [(amount recovered $ ) (amount charged off $ )] 9. Aggregate write-ins for other income or expenses 30. Net income or (loss) after capital gains tax and before all other federal income taxes (Lines 4 plus 7 plus 8 plus 9) XXX 3. Federal and foreign income taxes incurred XXX 3. Net income (loss) (Lines 30 minus 3) XXX DETAILS OF WRITE-INS 060. XXX 060. XXX 0603 XXX Summary of remaining write-ins for Line 6 from overflow page XXX Totals (Lines 060 thru 0603 plus 0698)(Line 6 above) XXX 070. XXX 070. XXX 0703 XXX Summary of remaining write-ins for Line 7 from overflow page XXX Totals (Lines 070 thru 0703 plus 0798)(Line 7 above) XXX Summary of remaining write-ins for Line 4 from overflow page 499. Totals (Lines 40 thru 403 plus 498)(Line 4 above) 90.! Summary of remaining write-ins for Line 9 from overflow page 999. Totals (Lines 90 thru 903 plus 998)(Line 9 above) 4

5 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. STATEMENT OF REVENUE AND EXPENSES (Continued) Current Year Prior Year CAPITAL AND SURPLUS ACCOUNT 33. Capital and surplus prior reporting year 34. Net income or (loss) from Line Change in valuation basis of aggregate policy and claim reserves 36. Change in net unrealized capital gains (losses) less capital gains tax of $ 37. Change in net unrealized foreign exchange capital gain or (loss) 38. Change in net deferred income tax 39. Change in nonadmitted assets 40 Change in unauthorized and certified reinsurance 4. Change in treasury stock 4. Change in surplus notes 43. Cumulative effect of changes in accounting principles 44. Capital Changes: 44. Paid in 44. Transferred from surplus (Stock Dividend) 44.3 Transferred to surplus 45. Surplus adjustments: 45. Paid in 45. Transferred to capital (Stock Dividend) 45.3 Transferred from capital 46. Dividends to stockholders 47. Aggregate write-ins for gains or (losses) in surplus 48. Net change in capital and surplus (Lines 34 to 47) 49. Capital and surplus end of reporting period (Line 33 plus 48) DETAILS OF WRITE-INS Summary of remaining write-ins for Line 47 from overflow page Totals (Lines 470 thru 4703 plus 4798)(Line 47 above) 5

6 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. CASH FLOW Current Year Prior Year Cash from Operations. Premiums collected net of reinsurance. Net investment income 3. Miscellaneous income 4. Total (Lines through 3) 5. Benefit and loss related payments 6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts 7. Commissions, expenses paid and aggregate write-ins for deductions 8. Dividends paid to policyholders 9. Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) 0. Total (Lines 5 through 9). Net cash from operations (Line 4 minus Line 0) Cash from Investments. Proceeds from investments sold, matured or repaid:. Bonds. Stocks.3 Mortgage loans.4 Real estate.5 Other invested assets.6 Net gains or (losses) on cash, cash equivalents and short-term investments.7 Miscellaneous proceeds.8 Total investment proceeds (Lines. to.7) 3. Cost of investments acquired (long-term only): 3. Bonds 3. Stocks 3.3 Mortgage loans 3.4 Real estate 3.5 Other invested assets 3.6 Miscellaneous applications 3.7 Total investments acquired (Lines 3. to 3.6) 4. Net increase (decrease) in contract loans and premium notes 5. Net cash from investments (Line.8 minus Line 3.7 minus Line 4) Cash from Financing and Miscellaneous Sources 6. Cash provided (applied): 6. Surplus notes, capital notes 6. Capital and paid in surplus, less treasury stock 6.3 Borrowed funds 6.4 Net deposits on deposit-type contracts and other insurance liabilities 6.5 Dividends to stockholders 6.6 Other cash provided (applied) 7. Net cash from financing and miscellaneous sources (Lines 6. to 6.4 minus Line 6.5 plus Line 6.6) RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS 8. Net change in cash, cash equivalents and short-term investments (Line, plus Lines 5 and 7) 9. Cash, cash equivalents and short-term investments: 9. Beginning of year 9. End of year (Line 8 plus Line 9.) Note: Supplemental disclosures of cash flow information for non-cash transactions: 6

7 7 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. ANALYSIS OF OPERATIONS BY LINES OF BUSINESS 3 4 Comprehensive Medicare Dental Vision Other Total (Hospital & Medical) Supplement Only Only Other Health Non-Health. Net premium income. Change in unearned premium reserves and reserve for rate credit 3. Fee-for-service (net of $ medical expenses) XXX 4. Risk revenue XXX 5. Aggregate write-ins for other health care related revenues XXX 6. Aggregate write-ins for other non-health care related revenues XXX XXX XXX XXX XXX XXX XXX XXX 7. Total revenues (Lines to 6) 8. Hospital/medical benefits XXX 9. Other professional services XXX 0. Outside referrals XXX. Emergency room and out-of-area XXX. Prescription drugs XXX 3. Aggregate write-ins for other hospital and medical XXX 4. Incentive pool, withhold adjustments and bonus amounts XXX 5. Subtotal (Lines 8 to 4) XXX 6. Net reinsurance recoveries XXX 7. Total medical and hospital (Lines 5 minus 6) XXX 8. Non-health claims (net) XXX XXX XXX XXX XXX XXX XXX XXX 9. Claims adjustment expenses including $ cost containment expenses 0. General administrative expenses. Increase in reserves for accident and health contracts XXX. Increase in reserves for life contracts XXX XXX XXX XXX XXX XXX XXX XXX 3. Total underwriting deductions (Lines 7 to ) 4. Total underwriting gain or (loss) (Line 7 minus Line 3) DETAILS OF WRITE-INS 050. XXX 050. XXX XXX Summary of remaining write-ins for Line 5 from overflow page XXX Totals (Lines 050 thru 0503 plus 0598) (Line 5 above) XXX 060. XXX XXX XXX XXX XXX XXX XXX XXX 060. XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Summary of remaining write-ins for Line 6 from overflow page XXX XXX XXX XXX XXX XXX XXX XXX Totals (Lines 060 thru 0603 plus 0698) (Line 6 above) XXX XXX XXX XXX XXX XXX XXX XXX 30. XXX 30. XXX 303. XXX 398. Summary of remaining write-ins for Line 3 from overflow page XXX 399. Totals (Lines 30 thru 303 plus 398) (Line 3 above) XXX 5 6 Federal Employees Health Benefits Plan 7 Title XVIII Medicare 8 Title XIX Medicaid 9 0

8 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT PART - PREMIUMS 3 4 Line of Business Direct Business Reinsurance Assumed Reinsurance Ceded Net Premium Income (Cols ). Comprehensive (hospital and medical). Medicare Supplement 3. Dental only 4. Vision only 5. Federal Employees Health Benefits Plan 6. Title XVIII - Medicare 7. Title XIX - Medicaid 8. Other health 9. Health subtotal (Lines through 8) 0. Life 8. Property/casualty. Totals (Lines 9 to )

9 9 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT Comprehensive (Hospital & Medical) PART - CLAIMS INCURRED DURING THE YEAR Medicare Supplement Total Dental Only Vision Only Other Health. Payments during the year:. Direct. Reinsurance assumed.3 Reinsurance ceded.4 Net. Paid medical incentive pools and bonuses 3. Claim liability December 3, current year from Part A: 3. Direct 3. Reinsurance assumed 3.3 Reinsurance ceded 3.4 Net 4. Claim reserve December 3, current year from Part D: 4. Direct 4. Reinsurance assumed 4.3 Reinsurance ceded 4.4 Net 5. Accrued medical incentive pools and bonuses, current year 6. Net healthcare receivables (a) 7. Amounts recoverable from reinsurers December 3, current year 8. Claim liability December 3, prior year from Part A: 8. Direct 8. Reinsurance assumed 8.3 Reinsurance ceded 8.4 Net 9. Claim reserve December 3, prior year from Part D: 9. Direct 9. Reinsurance assumed 9.3 Reinsurance ceded 9.4 Net 0. Accrued medical incentive pools and bonuses, prior year. Amounts recoverable from reinsurers December 3, prior year. Incurred Benefits:. Direct. Reinsurance assumed.3 Reinsurance ceded.4 Net 3. Incurred medical incentive pools and bonuses (a) Excludes $ loans or advances to providers not yet expensed. 6 Federal Employees Health Benefits Plan 7 Title XVIII Medicare 8 Title XIX Medicaid 9 0 Other Non-Health

10 . Reported in Process of Adjustment: Total ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT Comprehensive (Hospital & Medical) PART A - CLAIMS LIABILITY END OF CURRENT YEAR Medicare Supplement Dental Only Vision Only 6 Federal Employees Health Benefits Plan. Direct. Reinsurance assumed.3 Reinsurance ceded.4 Net 7 Title XVIII Medicare 8 Title XIX Medicaid 9 Other Health 0 Other Non-Health. Incurred but Unreported:. Direct. Reinsurance assumed.3 Reinsurance ceded.4 Net 0 3. Amounts Withheld from Paid Claims and Capitations: 3. Direct 3. Reinsurance assumed 3.3 Reinsurance ceded 3.4 Net 4. TOTALS: 4. Direct 4. Reinsurance assumed 4.3 Reinsurance ceded 4.4 Net

11 Line of Business ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT PART B - ANALYSIS OF CLAIMS UNPAID - PRIOR YEAR - NET OF REINSURANCE Claims Paid During the Year On Claims Incurred Prior to January of Current Year On Claims Incurred During the Year Claim Reserve and Claim Liability December 3 of Current Year 3 4 On Claims Unpaid December 3 of Prior Year On Claims Incurred During the Year 5 6 Claims Incurred In Prior Years (Columns + 3) Estimated Claim Reserve and Claim Liability December 3 of Prior Year. Comprehensive (hospital and medical). Medicare Supplement 3. Dental Only 4. Vision Only 5. Federal Employees Health Benefits Plan 6. Title XVIII - Medicare 7 Title XIX - Medicaid 8. Other health 9. Health subtotal (Lines to 8) 0. Healthcare receivables (a). Other non-health. Medical incentive pools and bonus amounts 3. Totals (Lines ) (a) Excludes $ loans or advances to providers not yet expensed.

12 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT PART C - DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Section A - Paid Health Claims - Title XVIII Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior XXX 4. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX.XV Section B - Incurred Health Claims - Title XVIII 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 XXX 4. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX Years in which Premiums were Earned and Claims were Incurred Section C - Incurred Year Health Claims and Claims Adjustment Expense Ratio - Title XVIII Claim and Claim Adjustment Expense Claim Adjustment (Col. 3/) Payments (Col. 5/) Claims Payment Expense Payments Percent (Col. + 3) Percent 7 8 Unpaid Claims Adjustment Expenses 9 Total Claims and Claims Adjustment Expense Incurred (Col ) Premiums Earned Claims Unpaid (Col. 9/) Percent

13 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT PART C - DEVELOPMENT OF PAID AND INCURRED HEALTH CLAIMS (000 Omitted) Section A - Paid Health Claims - Grand Total Cumulative Net Amounts Paid Year in Which Losses Were Incurred Prior XXX 4. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX.GT Section B - Incurred Health Claims - Grand Total 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 XXX 4. 0 XXX XXX XXX XXX XXX XXX XXX XXX XXX Years in which Premiums were Earned and Claims were Incurred Section C - Incurred Year Health Claims and Claims Adjustment Expense Ratio - Grand Total Claim and Claim Adjustment Expense Claim Adjustment (Col. 3/) Payments (Col. 5/) Claims Payment Expense Payments Percent (Col. + 3) Percent 7 8 Unpaid Claims Adjustment Expenses 9 Total Claims and Claims Adjustment Expense Incurred (Col ) Premiums Earned Claims Unpaid (Col. 9/) Percent

14 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT PART D - AGGREGATE RESERVE FOR ACCIDENT AND HEALTH CONTRACTS ONLY Total Comprehensive (Hospital & Medical) Medicare Supplement. Unearned premium reserves. Additional policy reserves (a) 3. Reserve for future contingent benefits 4. Reserve for rate credits or experience rating refunds (including Dental Only Vision Only 6 Federal Employees Health Benefits Plan $ ) for investment income 5. Aggregate write-ins for other policy reserves 6. Totals (gross) 7. Reinsurance ceded 8. Totals (Net)(Page 3, Line 4) 9. Present value of amounts not yet due on claims 0. Reserve for future contingent benefits. Aggregate write-ins for other claim reserves 7 Title XVIII Medicare 8 Title XIX Medicaid 9 Other 3. Totals (gross) 3. Reinsurance ceded 4. Totals (Net)(Page 3, Line 7) 050. DETAILS OF WRITE-INS Summary of remaining write-ins for Line 5 from overflow page Totals (Lines 050 thru 0503 plus 0598) (Line 5 above) Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 03 plus 98) (Line above) (a) Includes $ premium deficiency reserve.

15 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. UNDERWRITING AND INVESTMENT EXHIBIT. Rent ($ for occupancy of PART 3 - ANALYSIS OF EXPENSES Claim Adjustment Expenses Cost Containment Expenses Other Claim Adjustment Expenses General Administrative Expenses Investment Expenses Total own building). Salary, wages and other benefits 3. Commissions (less $ ceded plus $ assumed) 4. Legal fees and expenses 5. Certifications and accreditation fees 6. Auditing, actuarial and other consulting services 7. Traveling expenses 8. Marketing and advertising 9. Postage, express and telephone 0. Printing and office supplies. Occupancy, depreciation and amortization. Equipment 3. Cost or depreciation of EDP equipment and software 4. Outsourced services including EDP, claims, and other services 5. Boards, bureaus and association fees 6. Insurance, except on real estate 7. Collection and bank service charges 8. Group service and administration fees 9. Reimbursements by uninsured plans 0. Reimbursements from fiscal intermediaries. Real estate expenses. Real estate taxes 3. Taxes, licenses and fees: 3. State and local insurance taxes 3. State premium taxes 3.3 Regulatory authority licenses and fees 3.4 Payroll taxes 3.5 Other (excluding federal income and real estate taxes) 4. Investment expenses not included elsewhere 5. Aggregate write-ins for expenses 6. Total expenses incurred (Lines to 5) (a) 7. Less expenses unpaid December 3, current year 8. Add expenses unpaid December 3, prior year 9. Amounts receivable relating to uninsured plans, prior year 30. Amounts receivable relating to uninsured plans, current year 3. Total expenses paid (Lines 6 minus 7 plus 8 minus 9 plus 30) DETAILS OF WRITE-INS !"# Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 503 plus 598)(Line 5 above) (a) Includes management fees of $ to affiliates and $ to non-affiliates. 4

16 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. EXHIBIT OF NET INVESTMENT INCOME Collected During Year Earned During Year. U.S. government bonds (a). Bonds exempt from U.S. tax (a). Other bonds (unaffiliated) (a).3 Bonds of affiliates (a). Preferred stocks (unaffiliated) (b). Preferred stocks of affiliates (b). Common stocks (unaffiliated). Common stocks of affiliates 3. Mortgage loans (c) 4. Real estate (d) 5 Contract Loans 6 Cash, cash equivalents and short-term investments (e) 7 Derivative instruments (f) 8. Other invested assets 9. Aggregate write-ins for investment income 0. Total gross investment income. Investment expenses (g). Investment taxes, licenses and fees, excluding federal income taxes (g) 3. Interest expense (h) 4. Depreciation on real estate and other invested assets (i) 5. Aggregate write-ins for deductions from investment income 6. Total deductions (Lines through 5) 7. Net investment income (Line 0 minus Line 6) DETAILS OF WRITE-INS Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 090 thru 0903 plus 0998) (Line 9, above) Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 503 plus 598) (Line 5, above) (a) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (b) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued dividends on purchases. (c) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (d) Includes $ for company s occupancy of its own buildings; and excludes $ interest on encumbrances. (e) Includes $ accrual of discount less $ amortization of premium and less $ paid for accrued interest on purchases. (f) Includes $ accrual of discount less $ amortization of premium. (g) Includes $. investment expenses and $ investment taxes, licenses and fees, excluding federal income taxes, attributable to segregated and Separate Accounts. (h) Includes $ interest on surplus notes and $ interest on capital notes. (i) Includes $ depreciation on real estate and $ depreciation on other invested assets. EXHIBIT OF CAPITAL GAINS (LOSSES) Total Realized Capital Gain (Loss) (Columns + ) Change in Unrealized Capital Gain (Loss) Change in Unrealized Foreign Exchange Capital Gain (Loss) Realized Gain (Loss) On Sales or Maturity Other Realized Adjustments. U.S. Government bonds. Bonds exempt from U.S. tax. Other bonds (unaffiliated).3 Bonds of affiliates. Preferred stocks (unaffiliated). Preferred stocks of affiliates. Common stocks (unaffiliated). Common stocks of affiliates 3. Mortgage loans 4. Real estate 5. Contract loans 6. Cash, cash equivalents and short-term investments 7. Derivative instruments 8. Other invested assets 9. Aggregate write-ins for capital gains (losses) 0. Total capital gains (losses) DETAILS OF WRITE-INS Summary of remaining write-ins for Line 9 from overflow page Totals (Lines 090 thru 0903 plus 0998) (Line 9, above) 5

17 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. EXHIBIT OF NON-ADMITTED ASSETS Current Year Total Nonadmitted Assets Prior Year Total Nonadmitted Assets 3 Change in Total Nonadmitted Assets (Col. - Col. ). Bonds (Schedule D). Stocks (Schedule D):. Preferred stocks. Common stocks 3. Mortgage loans on real estate (Schedule B): 3. First liens 3. Other than first liens 4. Real estate (Schedule A): 4. Properties occupied by the company 4. Properties held for the production of income 4.3 Properties held for sale 5. Cash (Schedule E - Part ), cash equivalents (Schedule E - Part ) and short-term investments (Schedule DA) 6. Contract loans 7. Derivatives (Schedule DB) 8. Other invested assets (Schedule BA) 9. Receivables for securities 0. Securities lending reinvested collateral assets (Schedule DL). Aggregate write-ins for invested assets. Subtotals, cash and invested assets (Lines to ) 3. Title plants (for Title insurers only) 4. Investment income due and accrued 5. Premiums and considerations: 5. Uncollected premiums and agents'balances in the course of collection 5. Deferred premiums, agents'balances and installments booked but deferred and not yet due 5.3 Accrued retrospective premiums 6. Reinsurance: 6. Amounts recoverable from reinsurers 6. Funds held by or deposited with reinsured companies 6.3 Other amounts receivable under reinsurance contracts 7. Amounts receivable relating to uninsured plans 8. Current federal and foreign income tax recoverable and interest thereon 8. Net deferred tax asset 9. Guaranty funds receivable or on deposit 0. Electronic data processing equipment and software. Furniture and equipment, including health care delivery assets. Net adjustment in assets and liabilities due to foreign exchange rates 3. Receivable from parent, subsidiaries and affiliates 4. Health care and other amounts receivable 5. Aggregate write-ins for other than invested assets 6. Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines to 5) 7. From Separate Accounts, Segregated Accounts and Protected Cell Accounts 8. Total (Lines 6 and 7) DETAILS OF WRITE-INS 98. Summary of remaining write-ins for Line from overflow page 99. Totals (Lines 0 thru 03 plus 98)(Line above) Summary of remaining write-ins for Line 5 from overflow page 599. Totals (Lines 50 thru 503 plus 598)(Line 5 above) 6

18 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. EXHIBIT - ENROLLMENT BY PRODUCT TYPE FOR HEALTH BUSINESS ONLY Source of Enrollment Prior Year First Quarter Total Members at End of Current Year Second Quarter Third Quarter Current Year Member Months. Health Maintenance Organizations. Provider Service Organizations 3. Preferred Provider Organizations 4. Point of Service 5. Indemnity Only 6. Aggregate write-ins for other lines of business 7. Total DETAILS OF WRITE-INS Summary of remaining write-ins for Line 6 from overflow page Totals (Lines 060 thru 0603 plus 0698) (Line 6 above)

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44 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. GENERAL INTERROGATORIES PART - COMMON INTERROGATORIES GENERAL. Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer? If yes, complete Schedule Y, Parts, A and. If yes, did the reporting entity register and file with its domiciliary State Insurance Commissioner, Director or Superintendent, or with such regulatory official of the state of domicile of the principal insurer in the Holding Company System, a registration statement providing disclosure substantially similar to the standards adopted by the National Association of Insurance Commissioners (NAIC) in its Model Insurance Holding Company System Regulatory Act and model regulations pertaining thereto, or is the reporting entity subject to standards and disclosure requirements substantially similar to those required by such Act and regulations?.3 State Regulating?. Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of the reporting entity?. If yes, date of change: 3. State as of what date the latest financial examination of the reporting entity was made or is being made. 3. State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. This date should be the date of the examined balance sheet and not the date the report was completed or released. 3.3 State as of what date the latest financial examination report became available to other states or the public from either the state of domicile or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date). 3.4 By what department or departments? Florida Office of Insurance Regulations, Department of Life and Health Financial Oversight 3.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? 3.6 Have all of the recommendations within the latest financial examination report been complied with? 4. During the period covered by this statement, did any agent, broker, sales representative, non-affiliated sales/service organization or any combination thereof under common control (other than salaried employees of the reporting entity), receive credit or commissions for or control a substantial part (more than 0 percent of any major line of business measured on direct premiums) of: 4. sales of new business? 4. renewals? 4. During the period covered by this statement, did any sales/service organization owned in whole or in part by the reporting entity or an affiliate, receive credit or commissions for or control a substantial part (more than 0 percent of any major line of business measured on direct premiums) of: 4. sales of new business? 4. renewals? 5. Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? 5. If yes, provide the name of the entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation. Name of Entity NAIC Company Code 3 State of Domicile 6. Has the reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? 6. If yes, give full information: 7. Does any foreign (non-united States) person or entity directly or indirectly control 0% or more of the reporting entity? 7. If yes, 7. State the percentage of foreign control; 7. State the nationality(s) of the foreign person(s) or entity(s) or if the entity is a mutual or reciprocal, the nationality of its manager or attorney-in-fact; and identify the type of entity(s) (e.g., individual, corporation or government, manager or attorney in fact). Nationality Type of Entity 7

45 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. GENERAL INTERROGATORIES 8. Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? 8. If response to 8. is yes, please identify the name of the bank holding company. 8.3 Is the company affiliated with one or more banks, thrifts or securities firms? 8.4 If response to 8.3 is yes, please provide below the names and location (city and state of the main office) of any affiliates regulated by a federal regulatory services agency [i.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate's primary federal regulator. Affiliate Name Location (City, State) 3 FRB 4 OCC 5 FDIC 6 SEC 9. What is the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit? PricewaterhouseCoopers, LLC, 830 Cresent Center Drive, Suite 60, Nashville, TN Has the insurer been granted any exemptions to the prohibited non-audit services provided by the certified independent public accountant requirements as allowed in Section 7H of the Annual Financial Reporting Model Regulation (Model Audit Rule), or substantially similar state law or regulation? 0. If the response to 0. is yes, provide information related to this exemption: N/A 0.3 Has the insurer been granted any exemptions related to the other requirements of the Annual Financial Reporting Model Regulation as allowed for in Section 7A of the Model Regulation, or substantially similar state law or regulation? 0.4 If the response to 0.3 is yes, provide information related to this exemption: N/A 0.5 Has the reporting entity established an Audit Committee in compliance with the domiciliary state insurance laws? 0.6 If the response to 0.5 is no or n/a, please explain N/A. What is the name, address and affiliation (officer/employee of the reporting entity or actuary/consultant associated with an actuarial consulting firm) of the individual providing the statement of actuarial opinion/certification? David Terry, Cigna HealthSpring Inc 530 Great Circle Road, Nashville, TN 378. Does the reporting entity own any securities of a real estate holding company or otherwise hold real estate indirectly?. Name of real estate holding company. Number of parcels involved.3 Total book/adjusted carrying value $. If, yes provide explanation: 3. FOR UNITED STATES BRANCHES OF ALIEN REPORTING ENTITIES ONLY: 3. What changes have been made during the year in the United States manager or the United States trustees of the reporting entity? 3. Does this statement contain all business transacted for the reporting entity through its United States Branch on risks wherever located? 3.3 Have there been any changes made to any of the trust indentures during the year? 3.4 If answer to (3.3) is yes, has the domiciliary or entry state approved the changes? 4. Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code. 4. If the response to 4. is No, please explain: N/A 4. Has the code of ethics for senior managers been amended? 4. If the response to 4. is yes, provide information related to amendment(s). N/A 4.3 Have any provisions of the code of ethics been waived for any of the specified officers? 4.3 If the response to 4.3 is yes, provide the nature of any waiver(s). N/A 7.

46 ANNUAL STATEMENT FOR THE YEAR 04 OF THE HealthSpring of Florida, Inc. GENERAL INTERROGATORIES 5. Is the reporting entity the beneficiary of a Letter of Credit that is unrelated to reinsurance where the issuing or confirming bank is not on the SVO Bank List? 5. If the response to 5. is yes, indicate the American Bankers Association (ABA) Routing Number and the name of the issuing or confirming bank of the Letter of Credit and describe the circumstances in which the Letter of Credit is triggered. American Bankers Association (ABA) Routing Number Issuing or Confirming Bank Name 3 Circumstances That Can Trigger the Letter of Credit 4 Amount BOARD OF DIRECTORS 6. Is the purchase or sale of all investments of the reporting entity passed upon either by the board of directors or a subordinate committee thereof? 7. Does the reporting entity keep a complete permanent record of the proceedings of its board of directors and all subordinate committees thereof? 8. Has the reporting entity an established procedure for disclosure to its board of directors or trustees of any material interest or affiliation on the part of any of its officers, directors, trustees or responsible employees that is in conflict with the official duties of such person? FINANCIAL 9. Has this statement been prepared using a basis of accounting other than Statutory Accounting Principles (e.g., Generally Accepted Accounting Principles)? 0. Total amount loaned during the year (inclusive of Separate Accounts, exclusive of policy loans): 0. To directors or other officers $ 0. To stockholders not officers $ 0.3 Trustees, supreme or grand (Fraternal Only) $ 0. Total amount of loans outstanding at the end of year (inclusive of Separate Accounts, exclusive of policy loans): 0. To directors or other officers $ 0. To stockholders not officers $ 0.3 Trustees, supreme or grand (Fraternal Only) $. Were any assets reported in this statement subject to a contractual obligation to transfer to another party without the liability for such obligation being reported in the statement?. If yes, state the amount thereof at December 3 of the current year:. Rented from others $. Borrowed from others $.3 Leased from others $.4 Other $. Does this statement include payments for assessments as described in the Annual Statement Instructions other than guaranty fund or guaranty association assessments?. If answer is yes:. Amount paid as losses or risk adjustment $. Amount paid as expenses $.3 Other amounts paid $ 3. Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page of this statement? 3. If yes, indicate any amounts receivable from parent included in the Page amount: $ INVESTMENT 4.0 Were all the stocks, bonds and other securities owned December 3 of current year, over which the reporting entity has exclusive control, in the actual possession of the reporting entity on said date? (other than securities lending programs addressed in 4.03) 4.0 If no, give full and complete information relating thereto N/A 4.03 For security lending programs, provide a description of the program including value for collateral and amount of loaned securities, and whether collateral is carried on or off-balance sheet. (an alternative is to reference Note 7 where this information is also provided) N/A 4.04 Does the Company's security lending program meet the requirements for a conforming program as outlined in the Risk-Based Capital Instructions? 4.05 If answer to 4.04 is yes, report amount of collateral for conforming programs. $ 4.06 If answer to 4.04 is no, report amount of collateral for other programs. $ 4.07 Does your securities lending program require 0% (domestic securities) and 05% (foreign securities) from the counterparty at the outset of the contract? 4.08 Does the reporting entity non-admit when the collateral received from the counterparty falls below 00%? 4.09 Does the reporting entity or the reporting entity s securities lending agent utilize the Master Securities lending Agreement (MSLA) to conduct securities lending? 7.