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HPFSR ID: 2014 ChangeVref
2014 Change
Health Plan Information HPFSR ID: Health Plan Information
System Name #N/A101 NAIC Code :
#N/A102 NAIC Group Code
Mailing Address #N/A
#N/A
MA-City #N/AMA-County #N/A
MA-State #N/A
#N/A
Health Plan Information HPFSR ID: Phone #N/A
Fax #N/A
#N/A
Admin_Title #N/AAdmin_e-mail #N/A
CFO_Name #N/AWeb Site #N/A
Formset Preparer #N/A Preparer's Supervisor #N/A
#N/A108
#N/A109FP-Title #N/A 110 FP-Sup_Title #N/A
FP-Org_Name #N/A 111 FP-Sup e-mail #N/A
#N/A 112 FP-Sup_Phone #N/A
FP-City #N/AFP-County #N/A
FP-State #N/A
#N/A
FP-e-mail #N/AFP-Phone #N/A
FP-Ext #N/AFP-Fax #N/A
32Courtesy Contact 1 #N/A 95 Courtesy Contact 2 #N/A
#N/A54
#N/A55CC1-Title #N/A 56 CC2-Title #N/A
CC1-Org_Name #N/A 57 CC2-Org_Name #N/A
#N/A62
#N/A63CC1-City #N/A 64 CC2-City #N/A
CC1-County #N/A 65 CC2-County #N/ACC1-State #N/A 66 CC2-State #N/A
#N/A67
#N/A68CC1-e-mail #N/A 61 CC2-e-mail #N/ACC1-Phone #N/A 58 CC2-Phone #N/A
CC1-Ext #N/A 59 CC2-Ext #N/ACC1-Fax #N/A 60 CC2-Fax #N/A
MA-Address &MA-Mult Unit
MA-Zip5 &MA-Zip4
Admin_First_ Name &Admin_Last_Name
FP-First_Name &FP-Last_Name
FP-Sup_First_Name &FP-Sup_Last_Name
FP-Address & FP-Mult Unit
FP-Zip5 &FP-Zip4
CC1-First_Name &CC1-Last_Name
CC2-First_Name &CC2-Last_Name
CC1-Address &CC1-Mult Unit
CC2-Address & CC-2-Mult Unit
CC1-Zip5 &CC1-Zip4
CC2-Zip5 &CC2-Zip4
Health Plan Financial Statistical Report [email protected]
Page 2 of 34Instructions
Division of Health PolicyHealth Economics Program
2014 Instructions1 Statutory Requirements
2 Classifications of Data
3 Data Parametersa Data are for Minnesota Residents
b
c HPFSR Sections to be completed by Insurance CompaniesThe 2014 HPFSR includes the following sections:
1 Health Plan Company Identification2 Total 2014 Health Care Premium Received for Minnesota Residents3 Contact Information4 Medical Enrollment5 Dental Enrollment6 Revenue Sources7 Health Care Expenses8 Indirect Health Care Expenses9 Taxes and Assessments
10 Capital Costs11 Information Regarding Reporting
Health Plan Financial & Statistical Report (HPFSR)
The Health Plan Financial and Statistical Report (HPFSR) is a financial reporting tool that collects enrollment (membership), revenue and expense data from insurance companies on the health insurance coverage offered to and written for Minnesota residents.
Under Minnesota Statutes section 62J.38 and Minnesota Rules, Chapter 4652, insurance companies that are licensed to provide health insurance for Minnesota residents must submit the Health Plan Financial and Statistical Report (HPFSR) to MDH annually.
The following instructions address how your company's 2014 enrollment, revenue and expense data should be submitted on the 2014 HPFSR.
Minnesota Statutes, section 62J.38 Minnesota Rules 4652
Pursuant to Minnesota Statutes, section 62J.321, Subdivision 5, the data provided in this report are classified as nonpublic and can only be made public in an aggregated form.
Minnesota Statutes, section 62J.321
The data submitted in this report pertain to health insurance written for Minnesota residents only. A Minnesota resident is an enrollee or member listed in your company's enrollment records as having a zip code in Minnesota. You may use subscriber records if there are no records for each member. Include only company data for Minnesota residents.
Types of health and medical Insurance to be reported, and types of insurance that should be excluded from the 2014 HPFSR.The HPFSR should only include data related to health and medical care insurance coverage. Health insurance includes “health plans” as defined under Minnesota Statutes, section 62A.011 or “Accident and Sickness insurance” as defined under Minnesota Statutes, section 62A.01.
When reporting enrollment, revenue and expense data, exclude coverage that is related only to accidental death and dismemberment, short-term disability, long-term disability, long-term care, workers compensation, the medical component of automobile insurance, and personal accident coverage. If your company writes insurance for these excluded categories only, and does not offer another form of health or medical insurance, it does not need to file the HPFSR.
If you determine that your company does not offer health and medical insurance, please submit an email to MDH to explain the company's status for 2014.
[email protected] MN Statutes, section 62A.011 MN Statutes, section 62A.01
Health Plan Financial Statistical Report [email protected]
Page 3 of 34Instructions
Division of Health PolicyHealth Economics Program
d
1 Commercial2 Self-insured3
4
5
6 Medicare Supplement7 Medicare Part D Prescription Drug Plan.
Note Report Medicare revenue as follows:
Note Medicare Supplement and Medicare Part D – Dual Enrollment:
e Special product categories reported in Sections 2 and 4: 1
2
f Certifications required for submitting enrollment and financial data 1
2
3
All insurance companies licensed to market health insurance in Minnesota must complete Sections 1 through 3, regardless of the amount of premium revenue received in calendar year 2014. Companies that received less than $3,000,000 in total premium revenue should complete Sections 1 through 5. Insurance companies that received $3,000,000 or more in total premium revenue in should complete the entire HPFSR.
Product Categories: Enrollment, Revenue and Expenditure data should be reported in the following product categories:
Stop-loss (also known as reinsurance or excess loss policies) If your company provides stop-loss coverage for a self-insured employer for whom the company is also the third-party administrator, report these subscribers and expenditures in both the self-insured and stop-loss columns.
Minnesota Public Programs including Medical Assistance (MA), MinnesotaCare (MNCare), Minnesota Senior Health Options (MSHO) or other dual eligibles, and Minnesota Disability Health Options (MNDHO)
Medicare Advantage (formerly Medicare Cost and Medicare +Choice)
"Medicare Payments” = Total payments received from Medicare on behalf of enrollees. “Enrollee Payments” = Total premium payments received from enrollees for coverage.
If your company has members enrolled in both a Medicare Supplement and a stand-alone Medicare Part D Prescription Drug Plan, please report enrollment in both categories.
Small Employer Market: Report information for small employer business as defined in Minnesota Statutes Chapter 62L.02 and regulated under Minnesota Statutes Chapter 62L. Report data for Minnesota residents only. If your company does no business in Minnesota’s small employer market, enter zeros in the affected fields.
Minnesota Statutes, section 62L
Individual Market: Report for individual business as defined in Minnesota Statutes Chapter 62A.011 and regulated under Minnesota Statutes Chapter 62A.65. Report data for Minnesota residents only. If your company does no business in Minnesota’s individual market, enter zeros in the affected fields.
Minnesota Statutes, section 62A.011 Minnesota Statutes, section 62A.65
Companies with at $3 million or more in total health care premium for Minnesota residents must certify that revenue and expenses reported in the 2014 HPFSR are consistent with the company’s audited financial statements. This certification is indicated by the signature of an actuary or officer in Section 2 of the HPFSR.
Companies certifying that reported revenue and expense data are consistent with audited financial statements should provide a description of the methods used to determine revenue and expense data in Section 11 – Information Regarding Reporting in the “Explanations” worksheet tab.
Companies that market 80% or more of their business in Minnesota should reference appropriate entries from their audited financial statements for their entire book of business, or report experience for Minnesota residents only. Accounting and auditing methods should be applied consistently from year to year.
Health Plan Financial Statistical Report [email protected]
Page 4 of 34Instructions
Division of Health PolicyHealth Economics Program
4 Companies with 80% or less of their business in Minnesota shall have an actuary or financial officer certify that enrollment, revenue and expense data are calculated in a manner consistent with prior reporting years, and shall attach an accounting or actuarial memorandum describing methods used to identify and separate the Minnesota residents' data.
Health Plan Financial Statistical Report [email protected]
Page 5 of 34Instructions
Division of Health PolicyHealth Economics Program
4 Form Information and Securitya
b
cd
5 Additional Formatting within the formset:a
bcdef
g Grey shaded cells will automatically calculate values.
6 Errors in ReportsMDH will contact you if errors are identified.
7 Submitting ReportsEach company must submit the following by April 1, 2015:
a Completed 2014 Microsoft Excel™ HPFSR formset by e-mail to:
BK#rx&sG3
Excel 2003:
Excel 2007:
Excel 2010:
b
c Additional certifications or explanations as noted in these instructions.
8 Request for an Extension
9 QuestionsIf you have any questions about the HPFSR contact:
The Minnesota Department of Health (MDH) requires the use an electronic spreadsheet in completing this formset. This formset is a multiple tabbed Microsoft™ Excel spreadsheet. Tabs can be found along the bottom of the spreadsheet.
Please use your MDH assigned Health Plan ID found in the address block of your notification letter or can be selected from the Health Plan ID Tab.
Please report financial data in whole dollar amounts.
Please see 7a for instructions on how to password protect this formset before submission to MDH.
If data are combined with or included in a generalized category within a section of the report because breaking data into individual categories is not possible, enter all explanations in Section 11 of the report.
Leave any non-applicable items blank.
Error messages will show as RED text.
Tips throughout the report are highlighted in YELLOW.
Hyperlinks appear throughout the report for ease of navigation.
Orange shaded cells indicate data should be reviewed and corrected or verified and documented in Section 11.
[email protected] security purposes, you are encouraged apply a password to the file before sending by email. To apply the password to the file, go see instructions listed below. Use this password:
Go to Tools -> Options -> Security -> Apply Password -> Click OK -> Re-enter Password -> Click OK -> Save
Click on the MS Office Icon-> Prepare -> Encrypt Document -> Apply Password -> Click OK -> Re-enter Password -> Click OK -> Save
Go to File Tab -> Info -> Permissions -> Protect Workbook -> Encrypt with a Password -> Apply Password -> Click OK -> Re-enter Password -> OK -> Save
Company Information page with signature in Certification Statement block (PDF attached to an e-mail or faxed to 651-201-5179) This physical signature is required for all HPFSR filings, even if there is zero health care premium for the company reported.
Certification block
Expanations: Section 11
If the reporting company is unable to submit the report by April 1, 2015, a request for extension must be submitted in writing (e-mail is acceptable) by the due date and must include an explanation outlining why the extension is needed. Please send written requests for an extension on or before April 1, 2015, to:
Health Plan Financial Statistical Report [email protected]
Page 6 of 34Company Information
Division of Health PolicyHealth Economics Program
2014 Health Plan Financial and Statistical Report (HPFSR)Complete this page, print it and have it signed. Indicate any changes or corrections to data shown.
Section 1: Health Plan Company Identification Calendar Year 2014
NAIC Code:Group Code #N/A
Company Name #N/A
Administrator/CEO Name #N/ATitle
#N/A
Address #N/Ae-mail
#N/A
City #N/A Phone # #N/A
County #N/A Fax # #N/A
State #N/A website #N/A
Zip Code #N/A #N/A
Section 2: Total 2014 Health Care Premium for Minnesota Residents Calendar Year 2014
Total Medical Premium Revenue
Small employer medical premium revenue
Individual market medical premium revenue
Total Dental Premium Revenue Complete Company Identification,
0
Yes No
Certification Statement Calendar Year 2014
Signature
Print Name Date
Title
Health Plan ID Please click the link to the left, select the Health Plan ID from the list, return here and enter Health Plan ID.
Please VERIFY NAIC Code and Group Code
Mailing Address
CFO's Name
Total Health Care Premium Revenue Premium, and Contact Information
Does your Health Plan intend to do business in the state of Minnesota within the next three years?
Please be aware that you may be contacted in future reporting years to
verify your "No business" status.
I, the undersigned, an actuary or officer of the company, certify that the total premium, enrollment, expenditures, and revenue reported in the 2014 Health Plan Financial and Statistical Report (HPFSR) are consistent with the company's 2014 audited financial statements.
Should your Health Plan begin marketing in Minnesota, you are responsible for completing the Health Plan Financial and Statistical Report regardless of notification from the Minnesota Department of Health.
Health Plan Financial Statistical Report [email protected]
Page 7 of 34Company Information
Division of Health PolicyHealth Economics Program
#N/A
Section 3: Contact Information Calendar Year 2014
Preparer and Preparer's Supervisor (required)
#N/A Title #N/A
Organization Name #N/A
Address #N/A e-mail #N/A
City #N/A Phone # #N/A
County #N/A Phone Ext #N/A
State #N/A Fax # #N/A
Zip Code #N/A
Supervisor's Name #N/A Title #N/A
Supervisor's e-mail #N/A Phone #N/A
Courtesy Contact 1 (optional)
Courtesy Contact Name #N/A Title #N/A
Organization Name #N/A
Address #N/A e-mail #N/A
City #N/A Phone # #N/A
County #N/A Phone Ext #N/A
State #N/A Fax # #N/A
Zip Code #N/A
Courtesy Contact 2 (optional)
Courtesy Contact Name #N/A Title #N/A
Organization Name #N/A
Address #N/A e-mail #N/A
City #N/A Phone # #N/A
County #N/A Phone Ext #N/A
State #N/A Fax # #N/A
Zip Code #N/A
Name of Personcompleting this form
Health Plan Financial Statistical Report [email protected]
Page 8 of 34Enrollment
Division of Health PolicyHealth Economics Program
#N/A
Section 4: Medical Enrollment (Subscribers, Covered Lives, and Member Months) Calendar Year 2014
Yes No Please answer Yes or No
Commercial Self Insured Stop Loss MN Public Program
Total Medical Subscribers 0 0 0 0 0 0 0
Subscribers covering self only
Total Medical Covered Lives ###
Small Employer Market
Individual Market
Total Medical Member Months ###
NA NA NA NA NA NA NA
0000 0 0 0 0 0 0 0
Section 5: Dental Enrollment (Subscribers, Covered Lives, and Member Months) Calendar Year 2014
Yes No Please answer Yes or No
Commercial Self Insured Stop Loss MN Public Program
Total Dental Subscribers 0 0 0 0
Subscribers covering self only
Total Dental Covered Lives
Total Dental Member Months
NA NA NA NA
Audit Check
If your company has members enrolled in both a Medicare Supplemental plan and a stand-alone Medicare Part D Prescription Drug Plan, please report enrollment in both categories. Please document any explanations in Section 11
For more information or clarification see Definitions
Are medical lives from known data (not calculated)?
Indicate Yes or No.
Medicare Advantage
Medicare Supplement
Medicare Part D Prescription Drug
Subscribers covering self and dependents
Medicare Covered Lives with Drug Benefits
Average Member Monthsper Covered Life for 2014
Audit Check
For more information or clarification see Definitions
Are dental lives from known data (not calculated)?
Indicate Yes or No.
Please document any explanations in Section 11
Subscribers covering self and dependents
Average Member Monthsper Covered Life for 2014
Health Plan Financial Statistical Report [email protected]
Page 9 of 34Revenue
Division of Health PolicyHealth Economics Program
#N/A
Section 6: Revenue Sources Calendar Year 2014
Part A: Revenue from Medical and Dental Health Care Premiums
CommercialMedicare Advantage
Health Care Premium Revenue 0 0 0 0 0 0 0 0
Part B: Other Medical and Dental Revenue
CommercialMedicare Advantage
Other Payers
Administrative Services Fee
Reinsurance Assumed Revenue
Patient Services Revenue
Audit Check Please document any explanations in Section 11
For more information or clarification seeDefinitions Stop Loss &/or Self Insured
MN Public Program
Medicare Supplement
Medicare Part D Prescription Drug Plan
Medicare Payments
Enrollee Payments
Medicare Payments
Enrollee Payments
Medical Premium Revenue
Dental Premium Revenue
For more information or clarification seeDefinitions Stop Loss &/or Self Insured
MN Public Program
Medicare Supplement
Medicare Part D Prescription Drug Plan
Medicare Payments
Enrollee Payments
Medicare Payments
Enrollee Payments
Minimum Premium Plan Revenue
Utilization Fee
Health Plan Financial Statistical Report [email protected]
Page 10 of 34Expenses
Division of Health PolicyHealth Economics Program
#N/A
Section 7: Health Care Expenses (Medical and Dental) Total 2014 Health Care Expenses
Commercial Self Insured Stop Loss Medicare Advantage Medicare Supplement
Expense Category
Physician Services
Outpatient Services
Home Health Care
Emergency Services
Dental Services
Indirect Expense
Not Itemized Above
0 0 0 0 0 0 0 0 0 0 0 0
NA NA NA NA NA NA NA
Audit Check Please document any explanations in Section 11
For more information or clarification seeDefinitions
General Instructions for Section 7: Health Care Expenses
MN Public Program
Medicare Part D Prescription Drug Plan
Carrier Expense
Member Liability
Carrier Expense
Member Liability
Carrier Expense
Carrier Expense
Carrier Expense
Member Liability
Carrier Expense
Member Liability
Carrier Expense
Member Liability
Other Health Prof Services
Inpatient Hospital Services
Skilled Nursing Facilities
Pharmacy and Non-Durables
Durable Medical Goods
Chemical Depend/ Mental Health
Total 2014 Health Care Expenses
Administrative Expense as
percent of Total Expense
Health Plan Financial Statistical Report [email protected]
Page 11 of 34Indirect Expenses
Division of Health PolicyHealth Economics Program
#N/A
The data on this page will be published in the 2014 Administrative Costs at Minnesota Health Plans Report
Total Administrative Spending as percent of Total Carrier Spending: NA
Commercial Administrative Spending as percent of Commercial Spending: NA
MN Public Programs Administrative Spending as percent of MN Public Programs Spending: NA
NA
Section 8: Indirect Health Care Expenses (Medical and Dental) Calendar Year 2014
Indirect Expense Category Salaries and Benefits Other Expense
Billing and Enrollment 0
Claim Processing 0
Detection and Prevention of Fraud 0
Customer Service 0
Product Management and Marketing 0
Underwriting 0
0
Lobbying 0
Provider Relations and Contracting 0
0
Wellness and Health Education 0
Research and Product Development 0
Charitable Contributions 0
General Administration 0
Total Indirect Health Care Expenses 0 0 0
Section 9: Taxes and Assessments Calendar Year 2014
Do not include these taxes in the total indirect expenses above.
MinnesotaCare Tax
Other Taxes and Assessments
Section 10: Capital Costs Calendar Year 2014
2014 Incurred 2014 Payments
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures 0 0
Medicare Administrative Spending as percent of Medicare Spending (includes Medicare Advantage, Part D, and Medicare Supplement):
Audit Check
For more information or clarification see DefinitionsThe data may be estimated from existing accounting methods with allocation to specific categories. Please document estimation methods in Section 11. This data is Indirect expenses of non patient care.
Total Indirect Health Care Expense (by category)
Regulatory Compliance and Government Relations
Quality Assurance and Utilization Management
A more complete breakout of expenses is expected, please record expenses in the appropriate categories or document an explanation in Section 11. Please document any explanations in Section 11
For more information or clarification see Definitions
For more information or clarification see Definitions
Report any capital costs incurred this calendar year and any capital payments made this calendar year. Depreciation associated with these capital expenses are reported above as part of organizational expenses.
Capital Costs on Behalf of a Hospital or Clinic
Health Plan Financial Statistical Report [email protected]
Page 12 of 34Explanations
Division of Health PolicyHealth Economics Program
#N/A
Section 11: Information Regarding Reporting Calendar Year 2014
Section Number Explanation
Use the space below for elaborations or explanations for any of the information supplied on this form, or to document any changes in methods used from prior years' data. You can use the hyperlinks to return to specific sections in the form.
Section 1Company Identification
Section 2Total Health Care Premiums
Section 3Contact Information
Section 4Medical Enrollment
Section 5Dental Enrollment
Section 6Revenue Sources
Section 7Health Care Expenses
Section 8Indirect Health Care Expenses
Section 9Taxes and Assessments
Section 10Capital Costs
Health Plan Financial Statistical Report [email protected]
Page 13 of 34Audit Check
Division of Health PolicyHealth Economics Program
#N/A
Section
Total Medical Premium Revenues 0 0
0 0
Total Dental Premium Revenues
0 0
0 0
Indirect Expenses0 0
0 0
Enrollment and Revenues vs. Expenses
Items on this worksheet are for your reference and to be used as an aid in completing the formset. If your reported amounts do not fall within the audit parameters, you may be contacted by MDH for corrections.
Reported Amounts
If nothing shows in this column, your data has passed the initial audits
as reported in Section 2
as reported in Section 6
as reported in Section 2
as reported in Section 6
as reported in Section 8
as reported in Section 7
Medical Enrollment
Dental Enrollment
Medical Revenues vs. Expenses
Dental Revenues vs. Expenses
Health Plan Financial Statistical Report [email protected]
Page 14 of 34Definitions
Division of Health PolicyHealth Economics Program
2014 Health Plan Financial & Statistical Report (HPFSR) DefinitionsTerm: Definition:
Commercial
Self Insured
Stop Loss
MN Public Program
Medicare Advantage
Medicare Supplement
Other Payers
Total Subscribers
Section # link
Sec 4,5,6,7 Include all health insurance that are not included in the other categories. These products will include all small employer and individual policies.
Sec 4,5,6,7 Include health insurance products where the company does not bear risk for the claims of the covered lives, but provides administrative services only. If your company provides stop-loss coverage for a self-insured employer for whom the company is also the third-party administrator, report their enrollment, revenue, and expenditures in both the self-insured and stop-loss columns.
Sec 4,5,6,7 Include health insurance products otherwise known as reinsurance or excess loss policies. If your company provides stop-loss coverage for a self-insured employer for whom the company is also the third-party administrator, report their enrollment, revenue, and expenditures in both the self-insured and stop-loss columns.
Sec 4,5,6,7 Include Medical Assistance (MA), MinnesotaCare (MNCare), Minnesota Senior Health Options (MSHO), and Minnesota Disability Health Options (MNDHO). Report all data for Minnesota Senior Health Options (MSHO) or other dual eligibles in the MN Public Program category.
Sec 4,5,6,7 Includes all comprehensive Medicare plans (formerly known as Medicare Cost or "Medicare+Choice" plans).
Sec 4,5,6,7 Includes products which are sold commercially as supplemental coverage for Medicare recipients (known also as "Medigap" policies).
Sec 4,5,6,7 Medicare Part D Prescription Drug Plan
Includes all stand-alone Medicare prescription drug plans (only those sold as a separate product). Do not report in this category any enrollment, revenue, or expenditures for prescription drug coverage that is included as a benefit in a Medicare Advantage plan. If your company has members enrolled in both a Medicare Supplemental plan and a stand-alone Medicare Part D Prescription Drug Plan, please report enrollment in both categories.
Sec 6 Include revenue paid by other health insurers for patient services that are provided by your company.
Sec 2 Total Health Care Premium Revenue
Includes all premium charged on all health insurance policies written for Minnesota residents, including the change in unearned premium from the previous year, minus refunds based on experience. Report dental and medical premiums separately.
Sec 4,5 Subscribers are persons, not including dependents, enrolled under a contract for whom the company has responsibility for provision of health services, where the contract is directly between the person and the health plan company, or between the employer of the person and the health plan company. If contracts are between employers and the health plan company, provide a total count of the individuals who are the subscribers, not the total number of employers. Report the number of subscribers for your company as of December 31, 2014. Report medical and dental subscribers separately.
Sec 4,5 # of the Subscribers covering Subscriber only(as of December 31)
Number of Subscribers in "Subscriber-only" coverage means the total number of single employees enrolled in "individual coverage" under the health carrier's plans. Report the number of subscribers for your company as of December 31. Report medical and dental subscribers separately.
Sec 4,5 # of the Subscribers covering Subscriber and dependents(as of December 31)
Number of Subscribers in "Subscriber covering dependents" means the total number of employees who have family coverage (whose coverage includes dependents also covered under the health carrier's plans). Do NOT include the dependents in this total, include only the total number of subscribers. Report the number of subscribers for your company as of December 31. Report medical and dental subscribers separately.
Sec 4,5 Total Covered Lives(as of December 31)
All individuals enrolled as a subscriber or as an eligible dependent of a subscriber for whom your company has accepted the responsibility for the provision of basic health services under a contract. If the number of covered lives is not known, you may submit actuarial estimates of the total number of covered lives. Report the multiple used to estimate the total number of covered lives in the space provided. Covered lives are equivalent to “members” as defined in Minnesota Rules, Chapter 4652.0100 Subp.16. Include the number of covered lives for minimum premium plans in the commercial column. Report medical and dental covered lives separately. Report the covered lives for your company as of December 31.
Minnesota Rules, Chapter 4652.0100
Health Plan Financial Statistical Report [email protected]
Page 15 of 34Definitions
Division of Health PolicyHealth Economics Program
Term: Definition: Section #
link
Small Employer Market
Individual Market
Patient Services Revenue
Sec 4,5 Member Months(summed over 12 months)
One member month is the equivalent of one covered life for which the health plan company has premium revenue in one month. The total annual number of member months is calculated by summing the twelve end-of-month totals of covered lives for the reported year, for each product category. Report the member months as this sum of twelve end-of-month totals for the calendar year. Report medical and dental member months separately.
Sec 4,5 The market as defined in Minnesota Statutes Chapter 62L.02 and regulated under Minnesota Statutes Chapter 62L. Report these data under the commercial product category. Report these data for Minnesota residents only as of December 31, 2014. If your company does no business in Minnesota’s small employer market then enter zeros in the affected fields.
Minnesota Statutes, Chapter 62L
Sec 4,5 This is the market as defined in Minnesota Statutes Chapter 62A.011 and regulated under Minnesota Statutes Chapter 62A.65. Report these data under the commercial product category. Report this data for Minnesota residents only as of December 31, 2014. If your company does no business in Minnesota’s individual market then enter zeros in the affected fields.
Minnesota Statutes, Chapter 62A
Sec 4,5 Medicare Covered Lives with Drug Benefits
Subset of the reported covered lives that have included drug benefits in Medicare Advantage or Medicare Supplement coverage (that were not sold to them as a separate product).
Sec 6 Total Health Care Premium Revenue
Total premium revenue includes all premiums charged on all health insurance policies written for Minnesota residents, including the change in unearned premium from the previous year, minus refunds based on experience. Enter Medical and Dental premium received by product category in section 6, part A. Minimum premium revenue, administrative services fee revenue, utilization review fee revenues, reinsurance assumed revenue and patient services revenue should be reported in Part B. The autocalculated total across all columns for the row titled "Health Care Premium Revenue" in section 6, part A. should equal the total premium listed in section 2.
Sec 6 Minimum Premium Plan Revenue
Includes all revenue from insurance plan policies written for Minnesota residents where an employer self-funds a fixed percentage of the estimated monthly claims and the insurer covers the remainder. Please include the amount for any minimum premium plans in the commercial column.
Sec 6 Administrative Services Fee Revenue
Includes all revenue from fees related to health administrative services only (ASO) contracts written for Minnesota residents. An administrative services only contract means a contract between a health plan company and a third party, including a self-insured employer, for which the health plan company provides only claims administration and other services, without assuming risk.
Sec 6 Utilization Review Fee Revenue
Includes all revenue from fees related to health utilization review products written for Minnesota residents. This does not include utilization review revenue, which is part of premium revenue.
Sec 6 Reinsurance Assumed Revenue
Includes all revenue from reinsurance plan (stop-loss) policies for Minnesota residents received by a health plan company which writes reinsurance plan policies. This does not include payments received for reinsurance claims.
Sec 6 Includes fee-for-service revenue received for medical and dental services delivered to patients by clinics that are owned by the health plan company.
Sec 7 Section 7: General Instructions
Report member liability separately where there is a column for member liability. If detail is not available for Medicare Supplement, Stop-Loss, or coverage designed solely to provide payment on a per diem, fixed indemnity, or non-expense-incurred basis, report the expenses in “expenses not itemized above”. Estimate and report the indirect expenses for all carrier expense columns. MinnesotaCare 1.5% tax should be included in these expense categories. Do not itemize the MinnesotaCare 1.5% tax out of these expenses. Carrier expense is the net amount of expenses for which the health plan company is entirely responsible. Do not include in the carrier expense column expenses that will be recovered from the member, which is member liability. Member liability is the total amount payable by the member for health care services. This may include deductibles, copays, coinsurance, and amounts beyond plan coverage. If data regarding member liability are not available, an actuarially justified estimate is permissible.
Health Plan Financial Statistical Report [email protected]
Page 16 of 34Definitions
Division of Health PolicyHealth Economics Program
Term: Definition: Section #
linkPhysician services expenses
Outpatient services expenses
Home health care expenses
Dental services expenses Costs, professional and other, provided under dental services contracts or riders.
Indirect health care expenses
Sec 7 These are costs for all services provided by or under the supervision of licensed medical doctors and doctors of osteopathy, including pharmaceuticals and supplies administered or dispensed from the physician office and billed directly through the physician. Physician services expenses should exclude the costs of mental health services and chemical dependency services.
Sec 7 Other health professional services expenses
These are costs for all services provided by health professionals other than physicians and dentists, including chiropractors, therapists, social workers, nurse practitioners, and medical dental services. Other health professional services should exclude the costs of mental health services and chemical dependency services.
Sec 7 Inpatient hospital services expenses
These are costs for those services furnished by a hospital for inpatient services, including inpatient hospice care. Inpatient hospital services expenses should exclude costs of mental health and chemical dependency services.
Sec 7 These are costs for those services offered by a hospital which are furnished to ambulatory patients not requiring emergency care and for which there is not a room and board charge. Outpatient services expenses should exclude the costs of mental health services and chemical dependency services.
Sec 7 Skilled nursing facilities expenses
Costs for services furnished by a facility primarily engaged in providing skilled nursing care and related services for patients who require medical or nursing care or rehabilitation services. These expenses should include room and board incurred at skilled nursing facilities. Skilled nursing facilities expenses should exclude costs of mental health and chemical dependency services.
Sec 7 Costs for medical care services delivered in the home under the direction of a physician. This includes non-inpatient hospice care expenses.
Sec 7 Emergency services expenses
Costs for medical care provided in the emergency room of a hospital. This includes the room, board and any services such as x-ray and laboratory services billed by the facility. It does not include expenditures for physician services.
Sec 7 Pharmacy and other nondurable medical goods expenses
Costs paid by the health plan company to a pharmacist or medical supply company to provide pharmaceuticals and non-reusable supplies or pieces of equipment that are used to treat a health condition. These data do not include the cost of pharmaceuticals and other nondurable medical goods administered or dispensed which are billed directly through a hospital or health care provider.
Sec 7 Durable medical goods expenses
Costs for such items as wheel chairs, eyewear, hearing aids, surgical appliances, bulk and cylinder oxygen, equipment rental, and other devices or equipment that can withstand repeated use.
Sec 7 Chemical dependency and mental health expenses
Costs related to chemical dependency services and mental health services expense, for inpatient and outpatient services, coded using the following codes or amended equivalent codes: ICD-9 diagnosis code ranges 303.00 to 305.92, 290 to 302.9, and 306 to 319; CPT codes 90801, 90841, 90843, 90844, 90844.22, 90846, 90847, 90847.22, 90849, 90853, 98900, 98902, 98910, 98912, 90801, 90841, 90843, 90844, 90844.22, 90846, 90847, 90847.22, 90849, 90853, 98900, 98902, 98910, and 98912.
Do not include prescription drugs or supplies administered or dispensed that are billed directly through a hospital or health care provider. Expenses include all costs related to inpatient, outpatient, and other professional chemical dependency services and mental health services that are coded using codes from another coding system, where the commissioner determines that the codes indicate diagnoses or procedures comparable to or consistent with codes listed above. Health plan companies may use a nationally recognized standardized reporting system that captures chemical dependency or mental health inpatient, outpatient, and other professional services.
Sec 7
Sec 7 Costs for administrative parts of the business. Use the total from section 8 to allocate indirect health care expenditures across the product categories as outlined in the report. Do not include taxes and assessments in this line. Please note: The sum of indirect expenses across all product categories in section 7 should equal the total indirect health care expenses reported in section 8.
Health Plan Financial Statistical Report [email protected]
Page 17 of 34Definitions
Division of Health PolicyHealth Economics Program
Term: Definition: Section #
linkExpenses not itemized above
Total health care expenses
Claim processing expenses
Customer service expenses
Underwriting Carrier costs relating to underwriting.
Lobbying All carrier costs relating to lobbying.
Sec 7 All costs not itemized in the preceding categories. For coverage designed solely to provide payments on a per diem, fixed indemnity, or non-expense incurred basis, you may report total expenses in this line, rather than the categorized expenses (for example: fixed indemnity, capitated, and stop-loss payments that cannot be itemized).
Sec 7 This line is automatically totaled (it is the sum of detailed expense categories, for each product category).
Sec 8 Section 8: General Instructions
The data required for section 8 may be estimated from existing accounting methods with allocation to specific categories.
Sec 8 Billing and enrollment expenses
All costs associated with group and individual billing, member enrollment and premium collection and reconciliation functions. Billing and enrollment expenses include costs for the collection and reconciliation of cash, group and membership set-up and maintenance, contract, identification card, directory preparation and issuance, electronic data interchange expenses pertaining to billing and enrollment, and enrollment materials. Traditional expense categories, such as finance and information systems, may be allocated in whole or in part to billing and enrollment expenses.
Sec 8 All costs associated with the adjudication and adjustment of claims, coordination of benefits processing, maintenance of the claim system, printing of claim forms, claim audit functions, electronic data interchange expenses pertaining to claim processing, and fraud investigation. Traditional expense categories, such as information systems and legal, may be allocated in whole or in part to claims processing expenses.
Sec 8 All costs associated with individual, group, or provider support relating to membership, open enrollment, grievance resolution, claim problems, and specialized phone services and equipment. Traditional expense categories, such as information systems, finance, legal, and sales and marketing, may be allocated in whole or in part to customer service expenses.
Sec 8 Detection and Prevention of Fraud
Carrier costs relating to the detection and prevention of fraudulent or unjustified requests for reimbursement or actual payment of healthcare services.
Sec 8 Product management and marketing expenses
All costs associated with the management and marketing of current products, including costs relating to product promotion and advertising, sales, pricing, broker fees and commissions, internal commissions and commissions processing, marketing materials, account reporting, changes or additions to current products, and enrollee education regarding coverage. Traditional expense categories, such as information systems, underwriting, legal, finance, actuarial, public relations, and network management, may be allocated in whole or in part to product management and marketing expenses.
Sec 8
Sec 8 Regulatory compliance and government relations expenses
All costs associated with federal and state reporting, rate filing, state and federal audits, tax accounting, lobbying, licensing and filing fees, and costs associated with the preparation and filing of all financial, utilization, statistical, and quality reports, and administration of government programs. Traditional expense categories, such as information systems, finance, actuarial, sales and marketing, underwriting, contract, legal, utilization management, quality assurance, and compliance may be allocate in whole or in part to regulatory compliance and government relations expenses.
Sec 8
Sec 8 Provider relations and contracting expenses
All costs associated with contract negotiation and preparation, monitoring of provider compliance, field training with providers, provider communication materials and bulletins, and administration of provider capitations and settlements. Include also amounts paid to contractors, subcontractors and other entities for the purpose of distributing provider payments. Traditional expense categories, such as finance, legal, accounting, actuarial, and information systems may be allocated in whole or in part to provider relations and contracting expenses.
Sec 8 Quality assurance and utilization management expenses
Are all costs associated with quality assurance, practice protocol development, utilization review, peer review, credentialing, outcomes analysis related to existing products, nurse triage and other medical care evaluation activities. Include also amounts paid to contractors, subcontractors and other entities for the purpose of managing provider utilization. Traditional expense categories, such as information systems and legal may be allocated in whole or in part to quality assurance and utilization management expenses.
Health Plan Financial Statistical Report [email protected]
Page 18 of 34Definitions
Division of Health PolicyHealth Economics Program
Term: Definition: Section #
link
All costs related to contributions made for charitable purposes.
MinnesotaCare tax expenses
Capital Acquisitions
Other Capital Costs
Total Capital Expenditures Total of all the payments or incurred capital expenditures listed.
Sec 8 Wellness and health education expenses
All costs associated with wellness and health promotion, disease prevention, member education and materials, provider education, and outreach services. Traditional expense categories, such as marketing, medical services, and printing may be allocated in whole or in part to wellness and health education expenses.
Sec 8 Research and product development expenses
All costs associated with outcomes research, medical research programs, product design and development for products and programs not currently offered, major systems development, and integrated service network development. Traditional expense categories such as actuarial, information systems, marketing, finance, underwriting, and wellness programs may be allocated in whole or in part to research and product development expenses.
Sec 8 Charitable contributions expenses
Sec 8 General administration expenses
All costs not outlined or allocated to the other categories. Traditional expense categories such as human resources, facility maintenance, payroll, general accounting, finance, executive, internal audit, treasury, actuarial, information systems, office management and occupancy costs, general office supplies and equipment, legal, board, outside consulting services, membership fees in trade organizations, public relations, and mail room expenses may be allocated in whole or in part to general administration expenses. Taxes and assessments are not included in these costs.
Sec 8 Total indirect health care expenses
Should be equal to the sum across columns (product categories) for the indirect expenses line reported in section 7.
Sec 9 All payments paid to providers under Minnesota Statutes, section 295.582 and payments made as a provider under Minnesota Statutes, section 295.52, for the MinnesotaCare tax.
Sec 9 Other taxes and assessments expenses
All payments or amounts payable to government agencies, except for the MinnesotaCare tax, under Minnesota Statutes, section 295.52 and Minnesota Statutes, section 295.582. This category does not include fees or fines paid to government agencies.
Minnesota Statutes, section 295.52
Minnesota Statutes, section 295.582
Sec 10 Capital Costs on behalf of a hospital or clinic
All expenditures for capital that are incurred and/or paid on behalf of a hospital or clinic (or part of a partnership, joint venture, integration, or affiliation agreement). Report payments made during the calendar year (including lease payments) along with any costs incurred during the year.
Sec 10 All expenditures for the acquisition of capital assets. Report payments made during the calendar year (including lease payments) along with any costs incurred during the year.
Sec 10 Expenditures for other costs, such as legal or administrative costs, that are directly associated with the incurring of capital costs. Report payments made during the calendar year (including lease payments) along with any costs incurred during the year.
Sec 10
Health Plan Financial Statistical Report [email protected]
Page 19 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
11192 21st CENTURY ADVANTAGE INSURANCE COMPANY10004 21st CENTURY CENTENNIAL INSURANCE COMPANY11194 21st CENTURY NORTH AMERICA INSURANCE COMPANY10005 21st Century Premier Insurance Company11200 4 Ever Life Insurance Company11218 5 STAR LIFE INSURANCE COMPANY11219 AAA LIFE INSURANCE COMPANY10164 Ability Insurance Company11221 ACADIA INSURANCE CO10191 Accendo Insurance Company11223 ACCEPTANCE INDEMNITY INSURANCE COMPANY11756 Accordia Life and Annuity Company10618 ACE American Insurance Company11224 ACE FIRE UNDERWRITERS INSURANCE COMPANY10116 Ace Life Insurance Company10620 ACE Property and Casualty Insurance Company11225 ACUITY A MUTUAL INSURANCE COMPANY11228 AEGIS SECURITY INSURANCE COMPANY11229 AETNA HEALTH AND LIFE INSURANCE COMPANY11230 AETNA HEALTH INSURANCE COMPANY10003 Aetna Life Insurance Company11232 AFFILIATED FM INSURANCE COMPANY11328 AIG Property Casualty Company11233 AIU INSURANCE COMPANY11234 ALEA NORTH AMERICA INSURANCE COMPANY11235 ALLIANZ LIFE INSURANCE COMPANY OF NEW YORK10006 Allianz Life Insurance Company of North America10566 Allied Insurance Company of America11236 ALLIED WORLD INSURANCE COMPANY11748 ALLIED WORLD NATIONAL ASSURANCE COMPANY11237 ALLSTATE INDEMNITY COMPANY11238 ALLSTATE INSURANCE COMPANY10009 Allstate Life Insurance Company11557 Allstate Northbrook Indemnity Company11239 ALLSTATE PROPERTY AND CASUALTY INSURANCE COMPANY11496 ALTERRA AMERICA INSURANCE COMPANY10011 Amalgamated Life & Health Insurance Company 11241 AMALGAMATED LIFE INSURANCE COMPANY11242 American Alternative Insurance Corporation11243 AMERICAN AMICABLE LIFE INSURANCE COMPANY OF TEXAS11244 AMERICAN AUTOMOBILE INSURANCE COMPANY11245 AMERICAN BANKERS INSURANCE COMPANY OF FLORIDA11246 AMERICAN BANKERS LIFE ASSURANCE COMPANY OF FLORIDA11247 AMERICAN BENEFIT LIFE INSURANCE COMPANY10012 American Casualty Company of Reading, PA
2014 Health Plan Company ID List (alpha by Name)
Health Plan Financial Statistical Report [email protected]
Page 20 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
11248 AMERICAN CENTENNIAL INSURANCE COMPANY11249 AMERICAN COMMERCE INSURANCE COMPANY11250 American Continental Insurance Company11251 AMERICAN COUNTRY INSURANCE COMPANY11252 AMERICAN ECONOMY INSURANCE COMPANY10013 American Family Life Assur. Company of Columbus (AFLAC)11253 AMERICAN FAMILY LIFE INSURANCE COMPANY10014 American Family Mutual Insurance Company 10015 American Fidelity Assurance Company 11254 AMERICAN FIDELITY LIFE INSURANCE COMPANY10548 American General Life Insurance Company11258 AMERICAN GUARANTEE AND LIABILITY INSURANCE COMPANY10018 American Health & Life Insurance Company 10019 American Heritage Life Insurance Company 11259 AMERICAN HOME ASSURANCE COMPANY11260 American Income Life Insurance Company11261 AMERICAN INSURANCE COMPANY 10021 American Maturity Life Insurance Company 11265 American Memorial Life Insurance Company11267 AMERICAN MODERN LIFE INSURANCE COMPANY10022 American National Insurance Company 10023 American National Life Insurance Company of Texas10024 American Network Insurance Company 11269 AMERICAN PET INSURANCE COMPANY11270 AMERICAN PHYSICIANS ASSURANCE CORPORATION10025 American Progressive Life & Health Ins Company of NY11271 AMERICAN PUBLIC LIFE INSURANCE COMPANY11272 AMERICAN RELIABLE INSURANCE COMPANY11273 American Republic Corp Insurance Company10026 American Republic Insurance Company 11274 AMERICAN RETIREMENT LIFE INSURANCE COMPANY11276 AMERICAN SECURITY INSURANCE COMPANY11277 AMERICAN SENTINEL INSURANCE COMPANY11278 American Specialty Health Insurance Company11279 American States Insurance Company11280 AMERICAN STATES PREFERRED INSURANCE COMPANY11281 AMERICAN SUMMIT INSURANCE COMPANY10028 American United Life Insurance Company11282 AMERICAN ZURICH INSURANCE COMPANY11283 AMERICO FINANCIAL LIFE AND ANNUITY INSURANCE COMPANY10305 Ameritas Life Insurance Corp11284 AMEX ASSURANCE COMPANY11285 ANNUITY INVESTORS LIFE INSURANCE COMPANY10029 Anthem Life Insurance Company 11286 ARCH INSURANCE COMPANY11287 ARCH REINSURANCE COMPANY11288 ARGONAUT INSURANCE COMPANY11289 ARROWOOD INDEMNITY COMPANY11255 Ashmere Insurance Company11290 ASSOCIATED INDEMNITY CORPORATION10589 Assurity Life Insurance Company
Health Plan Financial Statistical Report [email protected]
Page 21 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10041 Athene Annuity & Life Assurance Company11601 Athene Annuity & Life Assurance Company of New York11202 Athene Annuity and Life Company11292 ATLANTA INTERNATIONAL INSURANCE COMPANY11293 ATLANTIC MUTUAL INSURANCE COMPANY10394 ATLANTIC SPECIALTY INSURANCE COMPANY11314 Aurigen Reinsurance Company of America11294 AURORA NATIONAL LIFE ASSURANCE COMPANY11295 AUTO CLUB INSURANCE ASSOCIATION11296 AUTO CLUB LIFE INSURANCE COMPANY11297 AUTO CLUB PROPERTY-CASUALTY INSURANCE COMPANY11298 AUTOMOBILE INSURANCE COMPANY OF HARTFORD, CONNECTICUT 11299 AUTO-OWNERS LIFE INSURANCE COMPANY11300 AVEMCO INSURANCE COMPANY11191 AXA Equitable Life & Annuity Company10031 AXA Equitable Life Insurance Company 11301 AXA INSURANCE COMPANY11303 AXIS INSURANCE COMPANY11304 AXIS REINSURANCE COMPANY11746 AXIS SPECIALTY INSURANCE COMPANY11305 BALBOA INSURANCE COMPANY11306 BALBOA LIFE INSURANCE COMPANY10032 Baltimore Life Insurance Company 10033 Bankers Fidelity Life Insurance Company10034 Bankers Life and Casualty Company10621 Banker's Standard Fire and Marine Company10622 Banker's Standard Insurance Company11308 BANNER LIFE INSURANCE COMPANY10036 BCS Insurance Company11309 BEAZLEY INSURANCE COMPANY, INC.11310 BENCHMARK INSURANCE COMPANY11311 BENEFICIAL LIFE INSURANCE COMPANY11312 BERKLEY INSURANCE COMPANY11750 BERKLEY LIFE AND HEALTH INSURANCE COMPANY11697 BERKLEY NATIONAL INSURANCE COMPANY10538 Berkshire Hathaway Specialty Insurance Company11313 BERKSHIRE LIFE INSURANCE COMPANY OF AMERICA10037 Blue Cross Blue Shield of Minnesota10038 Blue Plus10039 Boston Mutual Life Insurance Company 11315 BROTHERHOOD MUTUAL INSURANCE COMPANY11316 C. M. LIFE INSURANCE COMPANY10042 Canada Life Assurance Company, US Operations11318 CAPITOL INDEMNITY CORPORATION11320 CAROLINA CASUALTY INSURANCE COMPANY11522 Catamaran Insurance of Ohio, Inc.11321 CATERPILLAR INSURANCE COMPANY10536 Catlin Indemnity Company11322 CATLIN INSURANCE COMPANY, INC10044 Celtic Insurance Company11323 CENTENNIAL INSURANCE COMPANY
Health Plan Financial Statistical Report [email protected]
Page 22 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10045 Central States Health & Life Company of Omaha11324 CENTRAL STATES INDEMNITY CO. OF OMAHA10046 Central United Life Insurance Company 11325 CENTRE INSURANCE COMPANY11326 CENTRE LIFE INSURANCE COMPANY11327 CENTURION CASUALTY COMPANY10048 Centurion Life Insurance Company 10623 Century Indemnity Company10049 Charter National Life Insurance Company 11329 CHUBB NATIONAL INSURANCE COMPANY11330 CHURCH LIFE INSURANCE CORPORATION11331 CHURCH MUTUAL INSURANCE COMPANY11332 CICA LIFE INSURANCE COMPANY OF AMERICA10010 Cigna Health & Life Insurance Company11333 CINCINNATI CASUALTY COMPANY 11334 CINCINNATI INDEMNITY COMPANY11335 CINCINNATI INSURANCE COMPANY 10051 Cincinnati Life Insurance Company (The)11336 CLARENDON NATIONAL INSURANCE COMPANY11337 CLEARWATER SELECT INSURANCE COMPANY10075 CMFG Life Insurance Company11338 COFACE NORTH AMERICA INSURANCE COMPANY11339 COLISEUM REINSURANCE COMPANY10053 Colonial Life & Accident Insurance Company 10054 Colonial Penn Life Insurance Company 11340 Colorado Bankers Life Insurance Company10056 Columbian Life Insurance Company11341 COLUMBIAN MUTUAL LIFE INSURANCE COMPANY11342 COLUMBUS LIFE INSURANCE COMPANY10057 Combined Insurance Company of America 10059 Commercial Travelers Mutual Insurance Company 10007 Commonwealth Annuity and Life Insurance Company10060 Companion Life Insurance Company11343 COMPANION PROPERTY AND CASUALTY INSURANCE COMPANY11344 COMPASS INSURANCE COMPANY10061 Connecticut General Life Insurance Company 10064 Conseco Life Insurance Company10067 Constitution Life Insurance Company11346 CONSUMERS LIFE INSURANCE COMPANY10068 Continental American Insurance Company 10069 Continental Assurance Company 10070 Continental Casualty Company 10071 Continental General Insurance Company 10073 Continental Life Insurance Company of Brentwood TN11347 CONTINENTAL WESTERN INSURANCE COMPANY10397 Corvesta Life Insurance Company11348 COUNTRY INVESTORS LIFE ASSURANCE COMPANY10590 Country Life Insurance Company11349 CSI LIFE INSURANCE COMPANY11350 CUMIS INSURANCE SOCIETY INC11351 DAKOTA TRUCK UNDERWRITERS
Health Plan Financial Statistical Report [email protected]
Page 23 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10097 Dearborn National Life Insurance Company10973 Delaware American Life Insurance Company10076 Delta Dental Plan of Minnesota11353 Dentegra Insurance Company11354 DIAMOND STATE INSURANCE COMPANY11355 DIRECT GENERAL LIFE INSURANCE COMPANY11356 DISCOVER PROPERTY & CASUALTY INSURANCE COMPANY11645 DSM USA Insurance Company, Inc.11358 ECONOMY FIRE AND CASUALTY COMPANY11359 ECONOMY PREFERRED INSURANCE COMPANY11360 ECONOMY PREMIER ASSURANCE COMPANY11361 ELECTRIC INSURANCE COMPANY10077 EMC National Life11363 EMCASCO INSURANCE COMPANY11364 EMPIRE FIRE AND MARINE INSURANCE COMPANY11365 EMPLOYERS FIRE INSURANCE COMPANY 10079 Employers Reassurance Corporation11368 ENDURANCE REINSURANCE CORPORATION OF AMERICA11266 ENDURANCE RISK SOLUTIONS ASSURANCE CO.11739 Envision Insurance Company10080 EPIC Life Insurance Company11369 ERIE FAMILY LIFE INSURANCE COMPANY11371 EVEREST REINSURANCE COMPANY11372 EVERGREEN NATIONAL INDEMNITY COMPANY11373 EXECUTIVE RISK INDEMNITY INC11740 Express Scripts Insurance Company10215 Fair American Insurance and Reinsurance Company11375 FAIRMONT PREMIER INSURANCE COMPANY11376 FAIRMONT SPECIALTY INSURANCE COMPANY11457 Falls Lake National Insurance Company10083 Family Heritage Life Insurance Company of America11196 Family Life Insurance Company10084 Farm Bureau Life Insurance Company 11377 FARM BUREAU PROPERTY & CASUALTY INSURANCE COMPANY11378 FARMERS ALLIANCE MUTUAL INSURANCE COMPANY11379 FARMERS INSURANCE EXCHANGE10085 Farmers Mutual Hail Insurance Company of Iowa 11380 FARMERS NEW WORLD LIFE INSURANCE COMPANY11381 FARMINGTON CASUALTY COMPANY10086 Farmland Mutual Insurance Company 11382 FEDERAL INSURANCE COMPANY11383 FEDERAL LIFE INSURANCE COMPANY (MUTUAL)11384 FEDERATED LIFE INSURANCE COMPANY10088 Federated Mutual Insurance Company 11385 FEDERATED RURAL ELECTRIC INSURANCE EXCHANGE11386 FEDERATED SERVICE INSURANCE COMPANY11571 FIDELITY & GUARANTY LIFE INSURANCE COMPANY11387 FIDELITY AND DEPOSIT COMPANY OF MARYLAND11388 FIDELITY AND GUARANTY INSURANCE UNDERWRITERS, INC.11389 FIDELITY INVESTMENTS LIFE INSURANCE COMPANY11390 FIDELITY LIFE ASSOCIATION
Health Plan Financial Statistical Report [email protected]
Page 24 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10089 Fidelity Security Life Insurance Company 11319 FINANCIAL AMERICAN LIFE INSURANCE COMPANY11391 FIREMANS FUND INSURANCE COMPANY10091 First Allmerica Financial Life Insurance Company 11393 FIRST FINANCIAL INSURANCE COMPANY10094 First Health Life & Health Insurance Company10095 First Investors Life Insurance Company11394 FIRST LIBERTY INSURANCE CORPORATION 11396 FIRST NONPROFIT INSURANCE COMPANY11397 FIRST PENN-PACIFIC LIFE INSURANCE COMPANY11399 FOREMOST INSURANCE COMPANY11400 Forethought Life Insurance Company11401 Freedom Life Insurance Company of America10099 Garden State Life Insurance Company 11402 GEICO GENERAL INSURANCE COMPANY10104 General American Life Insurance Company 11403 GENERAL CASUALTY COMPANY OF WISCONSIN11404 GENERAL CASUALTY INSURANCE COMPANY11405 GENERAL FIDELITY LIFE INSURANCE COMPANY10106 General Re Life Corporation11406 GENERAL SECURITY NATIONAL INSURANCE COMPANY11407 GENERALI - UNITED STATES BRANCH11345 GENERATION LIFE INSURANCE COMPANY11408 GENESIS INSURANCE COMPANY10107 Genworth Life and Annuity Insurance Company10108 Genworth Life Insurance Company11410 Gerber Life Insurance Company11413 GLOBAL REINSURANCE CORPORATION OF AMERICA10109 Globe Life and Accident Insurance Company10111 Golden Rule Insurance Company11414 GOVERNMENT EMPLOYEES INSURANCE COMPANY11415 Government Personnel Mutual Life Insurance Company11416 GRANITE STATE INSURANCE COMPANY11417 GREAT AMERICAN INSURANCE COMPANY11418 GREAT AMERICAN INSURANCE COMPANY OF NEW YORK11419 Great American Life Insurance Company11420 GREAT DIVIDE INSURANCE COMPANY11421 GREAT MIDWEST INSURANCE COMPANY11422 GREAT NORTHERN INSURANCE COMPANY11424 GREAT SOUTHERN LIFE INSURANCE COMPANY11425 GREAT WEST CASUALTY COMPANY11426 GREATER NEW YORK MUTUAL INSURANCE COMPANY10112 Great-West Life & Annuity Insurance Company10113 Great-West Life Assurance Company 11427 GREENWICH INSURANCE COMPANY11428 GRINNELL MUTUAL REINSURANCE COMPANY10537 Grinnell Select Insurance Company11027 Group Health Plan, Inc.10114 Guarantee Trust Life Insurance Company11429 GUARDIAN INSURANCE & ANNUITY COMPANY, INC. 10115 Guardian Life Insurance Company of America
Health Plan Financial Statistical Report [email protected]
Page 25 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
11430 GUGGENHEIM LIFE AND ANNUITY COMPANY11431 GUIDEONE ELITE INSURANCE COMPANY11432 GUIDEONE MUTUAL INSURANCE COMPANY11028 Gundersen Lutheran Health Plan Minnesota11433 HARLEYSVILLE INSURANCE COMPANY11434 HARLEYSVILLE LIFE INSURANCE COMPANY11435 HARTFORD ACCIDENT AND INDEMNITY COMPANY11436 HARTFORD CASUALTY INSURANCE COMPANY10117 Hartford Fire Insurance Company 11437 HARTFORD INSURANCE COMPANY OF THE MIDWEST10120 Hartford Life & Accident Insurance Company 10121 Hartford Life & Annuity Insurance Company 10122 Hartford Life Insurance Company11438 HARTFORD UNDERWRITERS INSURANCE COMPANY10123 HCC Life Insurance Company 11439 HCSC Insurance Services Company11440 HDI-GERLING AMERICA INSURANCE COMPANY11441 Health Care Service Corporation, A Mutual Legal Reserve Company11442 Health Net Life Insurance Company11745 Health Net Life Insurance Company co/Health Net Ins of NY11020 Health Ventures Network10591 HealthMarkets Insurance Company10551 HealthPartners Insurance Company10124 HealthPartners, Inc.11741 HealthSpring Life & Health Insurance Company, Inc.10125 Heritage Casualty Insurance Company 10126 Heritage Life Insurance Company 11443 HERITAGE UNION LIFE INSURANCE COMPANY11751 HISCOX INSURANCE COMPANY INC.10389 HM Health Insurance Company10127 HM Life Insurance Company 11444 HOME INSURANCE COMPANY 11445 HOMESTEADERS LIFE COMPANY11446 HORACE MANN INSURANCE COMPANY10128 Horace Mann Life Insurance Company 11447 HORACE MANN PROPERTY & CASUALTY INSURANCE COMPANY11451 HUDSON INSURANCE COMPANY10226 Humana Benefit Plan of Illinois, Inc.10129 Humana Insurance Company10130 HumanaDental Insurance Company11452 IA AMERICAN LIFE INSURANCE COMPANY10131 IdeaLife Insurance Company11453 IDS PROPERTY CASUALTY INSURANCE COMPANY11454 ILLINOIS FARMERS INSURANCE COMPANY11471 ILLINOIS INSURANCE COMPANY10133 Illinois Mutual Life Insurance Company 11352 Imperium Insurance Company10624 Indemnity Insurance Company of North America11455 INDEPENDENCE AMERICAN INSURANCE COMPANY10134 Independence Life & Annuity Company 11456 INDIVIDUAL ASSURANCE COMPANY, LIFE, HEALTH & ACCIDENT
Health Plan Financial Statistical Report [email protected]
Page 26 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10138 Insurance Company of North America 11458 INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA 11459 INSURANCE CORPORATION OF NEW YORK 11460 INTEGON NATIONAL INSURANCE COMPANY11461 INTEGRITY LIFE INSURANCE COMPANY11462 Investors Life Insurance Company of North America11463 IOWA MUTUAL INSURANCE COMPANY10592 Ironshore Indemnity Inc.10139 Itasca Medical Care10140 Jackson National Life Insurance Company11464 JEFFERSON INSURANCE COMPANY10141 Jefferson National Life Insurance Company 10143 John Alden Life Insurance Company 11465 JOHN HANCOCK LIFE & HEALTH INSURANCE COMPANY10145 John Hancock Life Insurance Company (U.S.A.) 10146 Kanawha Insurance Company10147 Kansas City Life Insurance Company 11747 KEY RISK INSURANCE COMPANY11469 KNIGHTBROOK INSURANCE COMPANY10148 Knights of Columbus10149 Lafayette Life Insurance Company11470 LANCER INSURANCE COMPANY11472 LIBERTY INSURANCE CORPORATION10399 Liberty Insurance Underwriters Inc.10150 Liberty Life Assurance Company of Boston 11473 LIBERTY MUTUAL FIRE INSURANCE COMPANY11474 LIBERTY MUTUAL INSURANCE COMPANY11475 Liberty National Life Insurance Company11476 LIBERTY PERSONAL INSURANCE COMPANY10152 Life Insurance Company of North America11477 Life Insurance Company of the Southwest11478 LIFE OF THE SOUTH INSURANCE COMPANY10055 LifeSecure Insurance Company10246 Lincoln Benefit Life Company10154 Lincoln Benefit Life Insurance Company 11479 LINCOLN GENERAL INSURANCE COMPANY11480 Lincoln Heritage Life Insurance Company11481 LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK11482 LINCOLN MEMORIAL LIFE INSURANCE COMPANY10142 Lincoln National Life Insurance Company10155 Lincoln Republic Insurance Company11483 LM GENERAL INSURANCE COMPANY11484 LM INSURANCE CORPORATION11485 LM PROPERTY AND CASUALTY INSURANCE COMPANY11486 LONDON LIFE INSURANCE COMPANY11487 LONDON LIFE REINSURANCE COMPANY11488 LONGEVITY INSURANCE COMPANY11489 Loyal American Life Insurance Company11491 LYNDON PROPERTY INSURANCE COMPANY11492 LYNDON SOUTHERN INSURANCE COMPANY10156 Madison National Life Insurance Company, Inc.
Health Plan Financial Statistical Report [email protected]
Page 27 of 34Health Plan_ID
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Health_Plan_ID Name
11493 Maiden Reinsurance North America, Inc.10157 Manhattan Life Insurance Company 11494 MAPFRE INSURANCE COMPANY11495 MARKEL INSURANCE COMPANY10158 Massachusetts Mutual Life Insurance Company 11497 MEDAMERICA INSURANCE COMPANY10159 Medco Containment Life Insurance Company 10540 Medco Corp Life Insurance Company10160 Medica Health Plans10834 Medica Health Plans of Wisconsin10161 Medica Insurance Company10162 Medica Self Insured10163 Medico Insurance Company11499 MEDMARC CASUALTY INSURANCE COMPANY11620 Members Health Insurance Company11500 MEMBERS LIFE INSURANCE COMPANY11504 MERIT LIFE INSURANCE COMPANY11505 MERITPLAN INSURANCE COMPANY10257 MetLife Insurance Company USA10168 Metropolitan HealthPlan (MHP)10169 Metropolitan Life Insurance Company 11507 METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY10170 Metropolitan Tower Life Insurance Company 11508 MIC GENERAL INSURANCE CORPORATION11509 MID-CENTURY INSURANCE COMPANY11511 MIDDLESEX INSURANCE COMPANY11512 MIDLAND NATIONAL LIFE INSURANCE COMPANY11513 MidStates ReInsurance Corporation11467 Midvale Indemnity Company11514 MIDWEST EMPLOYERS CASUALTY COMPANY11515 MIDWEST FAMILY MUTUAL INSURANCE COMPANY10171 Mid-West National Life Insurance Company of Tennessee10173 Midwestern United Life Insurance Company 10174 MII Life, Incorporated11516 MILBANK INSURANCE COMPANY11517 MILWAUKEE CASUALTY INSURANCE CO.10391 Minnesota Life Insurance Company11519 MITSUI SUMITOMO INSURANCE COMPANY OF AMERICA11520 MITSUI SUMITOMO INSURANCE USA INC11521 MML BAY STATE LIFE INSURANCE COMPANY11523 MONARCH LIFE INSURANCE COMPANY10176 MONY Life Insurance Company11524 MONY LIFE INSURANCE COMPANY OF AMERICA11302 MOSAIC INSURANCE COMPANY10017 Motorists Commercial Mutual Insurance Company11525 MOTORISTS LIFE INSURANCE COMPANY11526 MTL INSURANCE COMPANY11527 MUNICH AMERICAN REASSURANCE COMPANY11528 MUNICH REINSURANCE AMERICA, INC.10545 Mutual of America Life Insurance Company10177 Mutual of Omaha Insurance Company
Health Plan Financial Statistical Report [email protected]
Page 28 of 34Health Plan_ID
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Health_Plan_ID Name
11529 NATIONAL AMERICAN INSURANCE COMPANY10179 National Benefit Life Insurance Company 10180 National Casualty Company11530 NATIONAL FARMERS UNION LIFE INSURANCE COMPANY11531 NATIONAL FARMERS UNION PROPERTY AND CASUALTY COMPANY10615 National Fire Insurance Company of Hartford11532 National Guardian Life Insurance Company10181 National Health Insurance Company 11533 NATIONAL INDEMNITY COMPANY11534 NATIONAL INDEMNITY COMPANY OF MID-AMERICA11535 NATIONAL INSURANCE COMPANY OF WISCONSIN, INC.11536 NATIONAL INTERSTATE INSURANCE COMPANY11537 NATIONAL LIFE INSURANCE COMPANY11539 NATIONAL SURETY CORPORATION11540 NATIONAL TEACHERS ASSOCIATES LIFE INSURANCE COMPANY11541 NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA.11542 NATIONWIDE AFFINITY INSURANCE COMPANY OF AMERICA11544 NATIONWIDE LIFE AND ANNUITY INSURANCE COMPANY10183 Nationwide Life Insurance Company 11546 NATIONWIDE MUTUAL FIRE INSURANCE COMPANY11547 Nationwide Mutual Insurance Company11548 NAU COUNTRY INSURANCE COMPANY11549 NAVIGATORS INSURANCE COMPANY10184 New England Life Insurance Company 11550 NEW HAMPSHIRE INSURANCE COMPANY10593 New York Life Insurance and Annuity Corporation10186 New York Life Insurance Company10187 Nippon Life Insurance Company of America11551 Noridian Mutual Insurance Company11552 NORTH AMERICAN COMPANY FOR LIFE AND HEALTH INSURANCE11553 NORTH AMERICAN ELITE INSURANCE COMPANY10188 North American Insurance Company 11554 NORTH AMERICAN SPECIALTY INSURANCE COMPANY11555 NORTH RIVER INSURANCE COMPANY 10189 Northwestern Long Term Care Insurance Company 11559 NORTHWESTERN NATIONAL INSURANCE COMPANY OF MILWAUKEE, WISCON11560 NOVA CASUALTY COMPANY10594 NYLIFE Insurance Company of Arizona11561 OCCIDENTAL FIRE & CASUALTY COMPANY OF NORTH CAROLINA11562 OCCIDENTAL LIFE INSURANCE COMPANY OF NORTH CAROLINA11563 ODYSSEY REINSURANCE COMPANY11564 OHIO CASUALTY INSURANCE COMPANY 11565 OHIO FARMERS INSURANCE COMPANY10192 Ohio National Life Assurance Corporation10194 Old American Insurance Company 11566 OLD REPUBLIC GENERAL INSURANCE CORPORATION11567 OLD REPUBLIC INSURANCE COMPANY10195 Old Republic Life Insurance Company 11568 OLD REPUBLIC SECURITY ASSURANCE COMPANY11569 OLD UNITED CASUALTY COMPANY11570 OLD UNITED LIFE INSURANCE COMPANY
Health Plan Financial Statistical Report [email protected]
Page 29 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10066 Omaha Insurance Company11573 ONEBEACON AMERICA INSURANCE COMPANY11574 ONEBEACON INSURANCE COMPANY11575 ONENATION INSURANCE COMPANY11576 OPTIMUM RE INSURANCE COMPANY10196 Oxford Life Insurance Company 10197 Ozark National Life Insurance Company 10625 Pacific Employers Insurance Company11577 PACIFIC INDEMNITY COMPANY10198 Pacific Life & Annuity Company 10199 Pacific Life Insurance Company 10308 Pacificare Life & Health Insurance Company11578 PAN-AMERICAN ASSURANCE COMPANY10392 Pan-American Life11580 PARK AVE LIFE INSURANCE COMPANY11581 PARKER CENTENNIAL ASSURANCE COMPANY11579 PARTNER RE AMERICA INSURANCE COMPANY11582 PARTNER RE INSURANCE COMPANY OF NEW YORK11583 PATRIOT GENERAL INSURANCE COMPANY10200 Paul Revere Life Insurance Company 11584 PAUL REVERE VARIABLE ANNUITY INSURANCE COMPANY 11450 Pavonia Insurance Company of Delaware11448 Pavonia Life Insurance Company of Michigan11585 PEKIN LIFE INSURANCE COMPANY11586 PENN INSURANCE AND ANNUITY COMPANY 11587 PENN MUTUAL LIFE INSURANCE COMPANY 11588 PENN TREATY NETWORK AMERICA INSURANCE COMPANY11590 PENNSYLVANIA INSURANCE COMPANY10202 Pennsylvania Life Insurance Company11591 PENNSYLVANIA LUMBERMENS MUTUAL INSURANCE COMPANY11592 PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY11593 PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY10588 Perico Life Insurance Company11594 PETROLEUM CASUALTY COMPANY10204 Philadelphia American Life Insurance Company 10395 PHILADELPHIA INDEMNITY INSURANCE COMPANY11595 PHILADELPHIA REINSURANCE CORPORATION10205 PHL Variable Insurance Company11596 PHOENIX INSURANCE COMPANY 10546 Phoenix Life Insurance Company11597 PHYSICIANS LIFE INSURANCE COMPANY10206 Physicians Mutual Insurance Company10207 Pioneer Mutual Life Insurance Company 11598 PIONEER SECURITY LIFE INSURANCE COMPANY11600 PRAETORIAN INSURANCE COMPANY10208 PreferredOne Community Health Plan10544 PreferredOne Insurance Company11602 PRIMERICA LIFE INSURANCE COMPANY10209 PrimeWest Health10210 Principal Life Insurance Company 11603 PRINCIPAL NATIONAL LIFE INSURANCE COMPANY
Health Plan Financial Statistical Report [email protected]
Page 30 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10211 Professional Insurance Company 11604 PROGRESSIVE PREFERRED INSURANCE COMPANY11605 PROTECTIVE INSURANCE COMPANY10212 Protective Life Insurance Company 10213 Provident Life and Accident Insurance Company 11606 PRUCO LIFE INSURANCE COMPANY11607 PRUDENTIAL ANNUITIES LIFE ASSURANCE CORPORATION10214 Prudential Insurance Company of America11608 PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY11609 PUBLIC SERVICE INSURANCE COMPANY11226 Puritan Life Insurance Company of America11610 PXRE REINSURANCE COMPANY10216 Pyramid Life Insurance Company 11611 QBE Insurance Corporation11612 QBE REINSURANCE CORPORATION11613 R&Q REINSURANCE COMPANY11614 R.V.I. America Insurance Company11615 RAM MUTUAL INSURANCE COMPANY11616 RAMPART INSURANCE COMPANY11617 REGENT INSURANCE COMPANY11618 RELIABLE LIFE INSURANCE COMPANY 10218 Reliance Standard Life Insurance Company 10220 ReliaStar Life Insurance Company10219 ReliaStar Life Insurance Company of New York11619 Renaissance Life & Health Insurance Company of America11621 REPWEST INSURANCE COMPANY10221 Resource Life Insurance Company11623 RGA REINSURANCE COMPANY11624 RIVERPORT INSURANCE COMPANY10132 RiverSource Life Insurance Company11625 RLI INDEMNITY COMPANY10222 RLI Insurance Company11626 S.USA LIFE INSURANCE COMPANY, INC.11627 SAFETY NATIONAL CASUALTY CORPORATION11628 SAGAMORE INSURANCE COMPANY11629 SAGICOR LIFE INSURANCE COMPANY11630 SAN FRANCISCO REINSURANCE COMPANY10234 Sanford HealthPlan of Minnesota 11632 SCOR GLOBAL LIFE AMERICAS REINSURANCE COMPANY11631 SCOR Global Life Reinsurance Company of Texas11633 SCOR REINSURANCE COMPANY11634 SCOTTISH RE (U.S.), INC.11635 SCOTTSDALE INDEMNITY COMPANY10224 Sears Life Insurance Company 11636 SEATON INSURANCE COMPANY11637 SECURIAN CASUALTY COMPANY10547 Securian Life Insurance Company11638 SECURITY BENEFIT LIFE INSURANCE COMPANY10228 Security Life Insurance Company of America10229 Security Life of Denver Insurance Company 11639 SECURITY NATIONAL LIFE INSURANCE COMPANY
Health Plan Financial Statistical Report [email protected]
Page 31 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10065 Senior Health Insurance Company of Pennsylvania11641 SENTRY CASUALTY COMPANY11642 SENTRY INSURANCE A MUTUAL COMPANY10231 Sentry Life Insurance Company11643 SENTRY LIFE INSURANCE COMPANY OF NEW YORK10232 Sentry Select Insurance Company 11742 ShelterPoint Insurance Company11398 ShelterPoint Life Insurance Company11644 SHENANDOAH LIFE INSURANCE COMPANY10539 Sierra Health and Life Insurance Company, Inc.11204 SilverScript Insurance Company10541 SIRIUS AMERICA INSURANCE COMPANY11227 SMART INSURANCE COMPANY10235 South Country Health Alliance11646 SPARTA INSURANCE COMPANY11647 ST. PAUL FIRE AND MARINE INSURANCE COMPANY11648 ST. PAUL GUARDIAN INSURANCE COMPANY11650 ST. PAUL MERCURY INSURANCE COMPANY11651 ST. PAUL PROTECTIVE INSURANCE COMPANY11652 STANDARD FIRE INSURANCE COMPANY 10236 Standard Insurance Company10237 Standard Life & Accident Insurance Company 10238 Standard Security Life Insurance Company of New York11654 STAR INSURANCE COMPANY11655 Starmount Life Insurance Company11656 STARNET INSURANCE COMPANY11657 STARR INDEMNITY & LIABILITY COMPANY11658 STATE FARM FIRE AND CASUALTY COMPANY11659 STATE FARM GENERAL INSURANCE COMPANY11660 STATE FARM LIFE INSURANCE COMPANY10239 State Farm Mutual Automobile Insurance Company 10240 State Life Insurance Company 11661 State Mutual Insurance Company11749 Sterling Investors Life Insurance Company10241 Sterling Life Insurance Company10243 Stonebridge Life Insurance Company 11662 STRATFORD INSURANCE COMPANY10306 Sun Life and Health Insurance Company (U.S.)10244 Sun Life Assurance Company of Canada 11664 SUNSET LIFE INSURANCE COMPANY OF AMERICA11665 SURETY LIFE INSURANCE COMPANY10247 Swiss Re Life and Health America Inc.11666 SWISS REINSURANCE AMERICA CORPORATION10248 Symetra Life Insurance Company 11667 SYMETRA NATIONAL LIFE INSURANCE COMPANY11723 Symphonix Health Insurance, Inc.11668 TEACHERS INSURANCE AND ANNUITY ASSOCIATION OF AMERICA11669 TEACHERS INSURANCE COMPANY11670 TEXAS LIFE INSURANCE COMPANY11275 The American Road Insurance Company10043 The Capitol Life Insurance Company
Health Plan Financial Statistical Report [email protected]
Page 32 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
10050 The Chesapeake Life Insurance Company 10072 The Continental Insurance Company 10165 The MEGA Life & Health Insurance Company 10190 The Northwestern Mutual Life Insurance Company 10193 The Ohio National Life Insurance Company 11572 THE OMAHA INDEMNITY COMPANY11291 THE TRAVELERS CASUALTY COMPANY10267 The Union Labor Life Insurance Company 10287 The Western & Southern Life Insurance Company 10249 Thrivent Financial for Lutherans10250 Thrivent Life Insurance Company 11671 TIAA-CREF LIFE INSURANCE COMPANY11672 TIG INSURANCE COMPANY10251 Time Insurance Company 11673 TNUS INSURANCE COMPANY10372 TOKIO MARINE AMERICA INSURANCE COMPANY11743 Torus National Insurance Company11675 TRANS PACIFIC INSURANCE COMPANY11676 TRANS WORLD ASSURANCE COMPANY11506 TRANSAMERICA ADVISORS LIFE INSURANCE COMPANY10242 Transamerica Casualty Insurance Company10252 Transamerica Financial Life Insurance Company 10254 Transamerica Life Insurance Company 10175 Transamerica Premier Life Insurance Company11677 TRANSGUARD INSURANCE COMPANY OF AMERICA, INC.11678 TRANSPORT INSURANCE COMPANY10614 Transportation Insurance Company11679 TRAVELERS CASUALTY AND SURETY COMPANY11680 TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA11681 TRAVELERS CASUALTY COMPANY OF CONNECTICUT11682 TRAVELERS COMMERCIAL INSURANCE COMPANY11649 TRAVELERS CONSTITUTION STATE INSURANCE COMPANY11683 TRAVELERS INDEMNITY COMPANY 11684 TRAVELERS INDEMNITY COMPANY OF AMERICA 11685 TRAVELERS INDEMNITY COMPANY OF CONNECTICUT 11686 TRENWICK AMERICA REINSURANCE CORPORATION11687 TRI-STATE INSURANCE COMPANY OF MINNESOTA11688 TRITON INSURANCE COMPANY10845 TruAssure Insurance Company11689 TRUCK INSURANCE EXCHANGE11690 TRUSTGARD INSURANCE COMPANY10259 Trustmark Insurance Company 10260 Trustmark Life Insurance Company 11691 TWIN CITY FIRE INSURANCE COMPANY10261 U.S. Specialty Insurance Company11692 UBS LIFE INSURANCE COMPANY USA10398 UCare Health, Inc.10262 UCare Minnesota10263 ULLICO Life Insurance Company 10264 UniCare Life & Health Insurance Company 11197 Unified Life Insurance Company
Health Plan Financial Statistical Report [email protected]
Page 33 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
11694 UNIMERICA INSURANCE COMPANY10266 Union Fidelity Life Insurance Company 11696 UNION INSURANCE COMPANY10268 Union Security Insurance Company 10269 United American Insurance Company 10270 United Concordia Insurance Company 11699 UNITED FIRE & CASUALTY COMPANY11700 UNITED HERITAGE LIFE INSURANCE COMPANY11701 UNITED HOME LIFE INSURANCE COMPANY11702 UNITED INSURANCE COMPANY OF AMERICA11704 UNITED LIFE INSURANCE COMPANY10272 United National Life Insurance Company of America10273 United of Omaha Life Insurance Company 11706 UNITED SECURITY ASSURANCE COMPANY OF PENNSYLVANIA11708 UNITED STATES FIDELITY AND GUARANTY COMPANY11709 United States Fire Insurance Company10393 United States Life Insurance Company in the City of New York10274 United Teacher Associates Insurance Company10275 United Wisconsin Insurance Company 10276 United World Life Insurance Company 10271 UnitedHealthcare Insurance Company 11264 UnitedHealthcare Life Insurance Company10278 Universal Guaranty Life Insurance Company 11713 UNIVERSAL UNDERWRITERS INSURANCE COMPANY11714 UNIVERSAL UNDERWRITERS LIFE INSURANCE COMPANY10279 Unum Life Insurance Company of America 11190 US Financial Life Insurance Company10280 USAA Life Insurance Company 10281 Usable Life11715 UTICA MUTUAL INSURANCE COMPANY10282 Valley Forge Insurance Company11716 VANTISLIFE INSURANCE COMPANY11718 VICTORIA FIRE & CASUALTY COMPANY11719 VIGILANT INSURANCE COMPANY11720 VIKING INSURANCE COMPANY OF WISCONSIN11721 VIRGINIA SURETY COMPANY, INC.11722 VISION SERVICE PLAN INSURANCE COMPANY10285 Volunteer Firefighters Benefit Association of Minnesota10137 Voya Insurance and Annuity Company10135 Voya Retirement Insurance and Annuity Company11724 WASHINGTON INTERNATIONAL INSURANCE COMPANY10286 Washington National Insurance Company 10542 WellCare Health Insurance Company of Kentucky, Inc.10002 WellCare Health Insurance of Arizona, Inc.11726 WESCO INSURANCE COMPANY11727 WEST COAST LIFE INSURANCE COMPANY10619 Westchester Fire Insurance Company11728 WESTERN NATIONAL ASSURANCE COMPANY11729 WESTERN NATIONAL MUTUAL INSURANCE COMPANY11730 WESTERN-SOUTHERN LIFE ASSURANCE COMPANY11731 WESTFIELD INSURANCE COMPANY
Health Plan Financial Statistical Report [email protected]
Page 34 of 34Health Plan_ID
Division of Health PolicyHealth Economics Program
Health_Plan_ID Name
11732 Westport Insurance Corporation11733 WILSHIRE INSURANCE COMPANY10616 Wilton Reassurance Company10020 Wilton Reassurance Life Company of New York11256 WOODRIDGE INSURANCE COMPANY10052 XL Insurance Company of New York, Inc.11734 XL LIFE INSURANCE AND ANNUITY COMPANY10396 XL REINSURANCE AMERICA INC.11735 YOSEMITE INSURANCE COMPANY11736 ZURICH AMERICAN INSURANCE COMPANY11737 ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS11468 ZURICH AMERICAN LIFE INSURANCE COMPANY
