Harmony Health Plan of Illinois, Inc. - IIS Windows Serverlibrary.corporate-ir.net/library/17/176/176521/items/294084/1Q2008... · HEALTH QUARTERLY STATEMENT OFTHE Harmony Health

HEALTH

QUARTERLY STATEMENT

OFTHE

Harmony Health Plan of Illinois, Inc.

OF

Chicago

IN THE STATE OF

Illinois

TO THE

INSURANCE DEPARTMENT

OF THE

STATE OF Illinois

AS OF

MARCH 31, 2008

2008

NooQ)

1111111 11111 11111 11111 1111111111 11111 11111 11111 11111 11111 II1111111111111111111111111111111111111 122 9 2 0 0 820 100 101

QUARTERLY STATEMENTAS OF MARCH 31, 2008

OF THE CONDITION AND AFFAIRS OF THE

Harmony Health Plan of Illinois, Inc.NAIC Group Code 1199

(Current Period)1199 NAIC Company Code 11229 Employer's ID Number 36-4050495

(Prior Period)

Organized under the Laws of Illinois , State of Domicile or Port of Entry Illinois

07/11/1996

Chicago, IL 60606

United States

Property/Casualty [ 1 Hospital, Medical & Dental Service or Indemnity [

Vision Service Corporation [l Health Maintenance Organization [ X 1Is HMO, Federally Qualified? Yes [ 1 No [ X 1

08/18/1995 Commenced Business

200 W. Adams Street, Eighth Floor

Incorporated/Organized

Statutory Home Office

Country of Domicile __ .. __..... _Licensed as business type: Life, Accident & Health [ 1

Dental Service Corporation [

Other [ 1

Mail Address

(Street and Number)

Main Administrative Office 8735 Henderson Road(Slreet and Number)

P.O. Box 31391

(City, Slale and Zip Code)

Tampa, FL 33634 813-243-2974(City or Town, State and Zip Code) (Area Code) (Telephone Number)

Tampa, FL 33631-3391

813-290-6200-1832(Area Code) (Telephone Number) (Extension)

813-283-5399

(City or Town, Stale and Zip Code)

Tampa, FL 33634 813-290-6200-1832(City, State and Zip Code) (Area Code) (Teiephone Number)

HarmonyhpLcom and Wellcare.com

(Name)Brian Keith Ollech

[email protected]

(Slreetand Number or P.O. Box)

Primary Location of Books and Records 8735 Henderson Road(Street and Number)

Internet Website Address

Statutory Statement Contact

(E-Mail Address) (Fax Number)

OFFICERSName

Heath Glenn SchiesserTitle

President, CEO and Treasurer

Name

Karen Williams Mulroe

TitleSecretary

Keith Alan Kudla Regional President

OTHER OFFICERS

Keith Alan KudlaHeath Glenn Schiesser

DIRECTORS OR TRUSTEESEdwin Earl Brooks Tina Rae Gallagher Karen Williams Mulroe

State of Florida __..__ __County of __Hillsborough.. 55

The officers of this reporting entity being duly swom, each depose and say that they are the described officers of said reporting entity, and that on the reporting period statedabove, 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 thatthis 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 andof 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 beencompleted in accordance with the NAIC Annual Statement Instructions and Accounting Practices and Procedures manual except to the extent that: (1) state law may differ; or, (2)that state rules or regulations require differences in reporting not related to accounting practices and procedures, according to the best of their information, knowledge and belief,respectively. Furthermore, the scope of this attestation by the described officers also includes the related corresponding electronic filing with the NAIC, when required, that is anexact 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,,~, """,,ct ,,",,m,,' L'~h1,~e, M.::n""W~i1"'Ii-am-s....,M-,-u,..lro-e------

President, CEO and Treasurer Secretary

Subscribed and sworn to before me thisday of ,

------.NmO""1""'AR,.,.,.y PUBLIC-S'l'AJ EOt' YWi{1LA-=-""""""-' Margo J. Brigg:iS• ~ CommIssion # Dl)0794a"""",,,,,.-=- Expires: JULY 13, 2011

;aOID)!m '!'HIm AThANTIe BONDING CO., INC.

/v!lg1/r~

a. Is this an original filing? Yes [ X J No [

b.lfno,1. State the amendment number2. Date filed3. Number of pages attached

STATEMENT AS OF MARCH 31, 2008 OF THE Harmony Health Plan of Illinois, Inc.

ASSETSCurrent Statement Date 4

2 3December 31

Net Admitted Assets I Prior Year NetAssets I Nonadmitted Assets I (CoIs. 1 - 2) Admitted Assets

1. Bonds + 6,134,200 ~ ! 6,134,200 ~ 6,141,9062. Stocks:

~:~ ~~~e;:~ ::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.t::::::::::::::::::::::::::::::::::::::t::::::::::::::::::::::::::::::::::::::t::::::::::::::::::::::::::::::::::~ t::::::::::::::::::::::::::::::::::~3. Mortgage loans on real estate:

::~ ~;~:~i~~:~.~~~~.;;~~~.::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~::::::::::::::::::::::::::::::::::::::t::::::::::::::::::::::::::::::::::::::t::::::::::::::::::::::::::::::::::~ ~::::::::::::::::::::::::::::::::::~4. Real estate:

4.1 Properties occupied by the company (less

$ encumbrances) ················t·····································l·····································t··············· 0 L O4.2 Properties held for the production of income

;~:~:~~':~;:~~=m:::~~~)~_:~:~-~~::t::_-::::t:::::::t:::::::: ~::::::5. Cash ($ .28,395, 156 ),

cash equivalents ($ 0

and short-term investments ($ 0 ) .28 ,395,156 .28,395,156 .22 ,860,164

6. Contract loans, (including $ premium notes) 0 07. Other invested assets 0 0 0 08. Receivables for securities . 0 09. Aggregate write-ins for invested assets 0 0 0 0

10. Subtotals, cash and invested assets (Lines 1 to 9) .34 ,529 ,356 0 34,529 ,356 29 ,002 ,07011. Title plants less $ charged off (for Title insurers

only) ······································t······································t······························....0 t·······························,··O12. Investment income due and accrued 138 ,905 138 ,905 91 ,39413. Premiums and considerations:

13.1 Uncollected premiums and agents' balances in the course of

collection l 55 ,457 ,154 ~ f 55,457,154 L 50,661 ,645

13.2 Deferred premiums, agents' balances and installments booked but

deferred and not yet due (including $ earned

~~~:::~:~~r::~us::~~;~~·~~~~;~~~:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::J::::::::::::::::::::::::::::::::::::::1::::::::::::::::::::::::::::::::::::::l::::::::::::::::::::::::::::::::::~ L::::::::::::::::::::::::::::::::~14. Reinsurance:

14.1 Amounts recoverable from reinsurers 3, 451,389 .3,451, 389 .2,428,93314.2 Funds held by or deposited with reinsured companies 0 014.3 Other amounts receivable under reinsurance contracts 0 0

15. Amounts receivable relating to uninsured plans . 0 016.1 Current federal and foreign income tax recoverable and interest thereon 1,059,524 . 1,059,524 3,472,80416.2 Net deferred tax asseL 5,840, 454 56 ,565 .5 ,783,889 .4,373,16217. Guaranlyfunds receivable oron deposit 0 018. Electronic data processing equipment and software 26 ,516 26 ,516 33 ,20519. Furniture and equipment, including health care delivery assets

($ ) -/- 194 ,573 ~ 194 ,573 ..................................0 0

20. Net adjustment in assets and liabilities due to foreign exchange rates ·····························~········l······································1······························ 0 021. Receivables from parent, subsidiaries and affiliates .2,480,681 .2 ,480,681 0 022. Health care ($ .450,724 ) and other amounts receivable....... . 553 ,507 21 ,460 532 ,047 336 ,34523. Aggregate write-ins for other than invested assets 2 ,006,752 1,573,745 .433 ,007 56 ,56224. Total assets excluding Separate Accounts, Segregated Accounts and

Protected Cell Accounts (Lines 10 to 23) 105,738,811 4,327,024 101,411,787 90,456,120

25. From Separate Accounts, Segregated Accounts and Protected

Cell Accounts.......................................................................................................... . 0 026. Total(Lines24and25) 105,738,811 4,327,024 101,411,787 90,456,120

DETAILS OF WRITE-INS

..................................0o

0901.

~:~:: ~~:::~::~;:~~::~;~;~~::~;~~;~~:;~:;:~;~~:~:;;~::~~~:;~ ::~~~~::.:.:::::::.:::.:::::::r:.:::::::::.::::.:::::: ::::::.::~::l::::::::::::::::·:·:::::::·:·:·:::~::t::::::::::.:.:::.:::::::: ..:::::::~--t- ················1

0999. Totals (Lines 0901 throuQh 0903 plus 0998)(Line 9 above) toot 0

~:~:: :;~:~g:~~e::~;~:::~:::.:~:~~~~~..~:~~:~~~.~~:::::::::.::::::::.::::::::::::::::::::::::::.::::::1 =:-:=:;:~:; =_~:_:=;;:;~_==:__~,oo:2398. Summary of remaining write-ins for Line 23 from overflow page 1,526 ,443 1,526 ,443 02399. Totals (Lines 2301 throuQh 2303 plus 2398)(Line 23 above) 2,006,752 1,573,745 433,007

.........................56,562

..................................0

..................................0

..................................056,562

2


LIABILITIES, CAPITAL AND SURPLUSCurrent Period Prior Year

1Covered

2Uncovered

3Total

4Total

1. Claims unpaid (less $ reinsurance ceded) 61 ,656 ,312 .. 61,656,312 47,641,243

2. Accrued medical incentive pool and bonus amounts .. 0 0

3. Unpaid claims adjustment expenses 1,179,443 .. 1,179,443 ..780,866

4. Aggregate health policy reserves .. 0 0

5. Aggregate life policy reserves .. 0 0

6. Property/casualty uneamed premium reserve .. 0 0

7. Aggregate health claim reserves .. 0 0

8. Premiums received in advance 0 0

9. General expenses due or accrued 3,373,317 3,373,317 3,426 ,072

10.1 Current federal and foreign income tax payable and interest thereon (inclUding

$ on realized gains (losses» 0 0

10.2 Net deferred tax liability 0 0

11. Ceded reinsurance premiums payable .. .4,291,895 .. .4,291,895 3,912,248

12. Amounts withheld or retained for the account of others .. 0 0

13. Remittances and items not allocated 353,290 .. 353,290 246 ,269

14. Borrowed money (inclUding $ current) and

interest thereon $ (including

..................................0

..................2,324,867

..................................0

..................................0

..................................0

..................................0

...................1,304,170

:: ::.~f:=:,:::~;=:_:"~:,;:-=:-=::::::l:::==_~l~.;~J=:-::::-::::t:::-:~l'~~17. Funds held under reinsurance treaties with ($ ..

authorized reinsurers and $ unauthorized

18. ;:~::~~:~c:..;~..~~~:;~~~·~:·~·:~~:·~;:~·:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::1:::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::~19. Net adjustments in assets and liabilities due to foreign exchange rates .. 0

20. Liability for amounts held under uninsured plans 2,245,890 .. 2,245,890

21. Aggregate write-ins for other liabilities (including $

current) 1,752,653 0 1,752,653 804, 994

22. Total liabilities (Lines 1 to 21) .75,071 ,569 0 .75,071 ,569 60,440,729

23. Aggregate write-ins for special surplus funds XXX XXX 0 0

24. Common capital stock . XXX XXX.............. .. 0

25. Preferred capital stock XXX XXX.............. .. 0

26. Gross paid in and contributed surplus XXX XXX 23,354,899 23,354,899

27. SurplUS notes XXX XXX 0

28. Aggregate write-ins for other than special surplUS funds .. XXX XXX 0 0

29. Unassigned funds (surplUS) .. XXX XXX 2,985,319 6,660 ,492

30. Less treasury stock, at cost:

30.1 shares common (value included in Line 24)

$ ..............................................................................+ XXX ~ XXX ~ j. 0

30.2 shares preferred (value included in Line 25)

$

: ~::::~:~~:::"~~::I:fu:~~:"~;:,;~;:==:=:F=::=:r==;=+:=;:,::~·:::r=:·::·:

..................................0

o


2101. Liabi I ity for Retrospect ive premium. ~ 1,752,653 ~ t 1,752,653 L 804,994

2102.

2103.

2198. Summary of remaining write-ins for Line 21 from overflow page .. 0 0 0 0

2199. Totals lLines 2101 thru 2103 olus 2198) lLine 21 above) 1,752,653 0 1,752,653 804,994

2301. .. XXX XXX.............. .. ..

2302. . XXX xxx............... . .2303. .. XXX XXX .

2398. Summary of remaining write-ins for Line 23 from overflow page .. XXX XXX 0

2399. Totals lLines 2301 thru 2303 olus 2398) lLine 23 above) XXX XXX.............. 0

..................................0

o

:::::_=::::::::::_-:_-::::-:::::;:::::s::::::1:::::::2898. Summary of remaining write-ins for Line 28 from overflow page .. xxx xxx 0

2899. Totals lLines 2801 thru 2803 olus 2898) lLine 28 above) XXX XXX 0

3


STATEMENT OF REVENUE AND EXPENSES

Current Year I Prior Year To-To Date Date

1 I 2 I 3Uncovered Total Total

1. Member Months xxx. 448,929 322,928

2. Net premium income (including $ non-health premium income) xxx. 76, 179,520 44,230,985

3. Change in unearned premium reserves and reserve for rate credits . xxx. 04. Fee-for-service (net of $ medical expenses) xxx. 0

5. Risk revenue . xxx. D6. Aggregate write-ins for other health care related revenues xxx. D 0

7. Aggregate write-ins for other non-health revenues . xxx. 0 08. Total revenues (Lines 2 to 7) xxx. 76, 179,520 44,230,985

Hospital and Medical:

9. Hospital/medical benefits 60,658,308 27,043,893

10. Other professional services 2,829 ,930 1,318,579

11. Outside referrals . 0

12. Emergency room and out-of-area 1,459,276 720 ,351

13. Prescription drugs 3,499,541 2,918,527

14. Aggregate write-ins for other hospital and medicaL...................................................................... . D .......•.•.•.......•.••......0 D15. Incentive pool, withhold adjustments and bonus amounts 0

16. Subtotal (Lines 9to 15) 0 68,447,055 32,001,350

Less:

Prior YearEnded

December 314

Total

.............1,503,965

.........223,393,657

.............................0

•..........•................D

.............................0

............................D

.............................0

.........223,393,657

..........165 ,567 ,910

.............7,705,000

.............................0

.............5,325,437

.............8,801,813

..•.•.........•.••.........•D

..............................0

..........187,400,160

.............4,044, 162

.............4 ,632,195(588,033\

.............8,907 ,345

..........178,492,815

.............................0

.............6,904 ,853

...........35,874,510

.............................0

.........221,272,178

.............2,121,479

.............1,922,683

.............................0

.............1,922,683

17. Net reinsurance recoveries 2, 789,216 .3,502,425

18. Total hospital and medical (Lines 16 minus 17) D 65,657,839 28,498,925

19. Non-health claims (net) D20. Claims adjustment expenses, inclUding $ 984,868 cost containment expenses 3,024,891 841 ,922

21. General administrative expenses 11 ,941 ,647 7,607 ,574

22. Increase in reserves for life and accident and health contracts including

$ increase in reserves for life only) 0

23. Total underwriting deductions (Lines 18 through 22) 0 80,624,377 36,948,421

24. Net underwriting gain or (loss) (Lines 8 minus 23) xxx. (4,444,857) .7 ,282,564

25. Net investment income earned 265,697 485,773

26. Net realized capital gains (losses) less capital gains tax of $ 0

27. Net investment gains (losses) (Lines 25 plus 26) D .265,697 .485 ,773

28. Net gain or (loss) from agents' or premium balances charged off [(amount recovered

29. :g~·;~~~~:·:~~:~;~~·;~~·:~~·~r(~n::~::~:~:::::s~ ....::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::~ ..t::::::::::::::::::::::::::::~ ..t::::::::::::::::::::::::::::~ t::::::::::::::::::::::::::::~30. Net income or (loss) after capital gains tax and before all other federal income taxes (Lines

24 plus 27 plus 28 plus 29) ·············xxx.···········f··········· (4,179,160) f······ ···.7 ,768,33731. Federal and foreign income taxes incurred xxx. (593,468) 3,485 ,223

32. Netincome (loss)(Lines 30 minus 31) XXX (3,585,692) 4,283,114


. ·················································1·············xxx.··········t······························t······························t·······························1

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::r:::::::::::::::::::::::::::::r:::::::::::::::::::::::::::::r::::::::::::::::::::::::::::::

0601.

0602.

0603.

0698.

0699.~~:I:~~n:Sr~~a~nt:~::~e~~~3f:~U~~:::;~:n:v::~:v:;ge ·················································t············::·········t···························~ . Dt o

o 0

•••••......•••......•.•••....0 t O

o 0

0701.

0702.

0703.

0798.

0799.

1401.

1402.

1403.

1498.

1499.

:::-::-::::::::_:-:::_:::::-::::-::::::2:::::::=l=-==:::::E::=:::Summary of remaining write-ins for Line 7 from overflow page xxx. DTotals (Lines 0701 throuQh 0703 plus 0798) (Line 7 above) XXX 0

~~::~~n:sr~;oa~n:~:;~e1-;;3f:~U~~:::)f~:~eO~::::v:;ge ·················································t···· ~ t·····························~ t····························~ t·····························~

2901.

2902.

2903.

~:::: ~~:I:~~n::r:;oa~nt:r~::~e;~n;3f:~u~::::)f~~:eO~::::v:~ge ~ ~ ~ ~ ~ ~ ~ ~

4

STATEMENT AS OF MARCH 31, 2008 OF THE Harmony Health Plan of l1Iinois, Inc.

STATEMENT OF REVENUE AND EXPENSES (Continued)1 I 2 I 3Current Year Prior Year

to Date to Date Prior Year

CAPITAL AND SURPLUS ACCOUNT:

33. Capital and surplus prior reporting year J, 30 ,015 ,391 L 28 ,083 ,743 L,. .28 ,083,743

34. Net income or (loss) from Line 32 ). (3 ,585 ,692) L 4,283,114 L (588 ,033)

35. Change in valuation basis of aggregate policy and claim reserves ). .\. D L.. D

36. Change in net unrealized capital gains (losses) less capital gains tax of $ .......................................1- 1- .492 L. D

37. Change in net unrealized foreign exchange capital gain or (loss) ~ t DL.. D

38. Change in net deferred income tax ,L 1,410,079 L 880 ,432 L. 3,313,030

39. Change in nonadmitted assets : ). (1 ,499,560) L (69 ,303) L (792 ,442)

40. Change in unauthorized reinsurance : l D L. D L. D

41. Change in treasury stock L. !. D L. D

42. Change in surplus notes L. D L. D L D

43. Cumulative effect of changes in accounting principles 1.. 1.. D L. D

44. Capital Changes:

44.1 Paid in l .\. DL. D

44.2 Transferred from surplUS (Stock Dividend) j. t D L. D

44.3 Transferred to surplus L .\. D L. D

45. Surplus adjustments:

45.1 Paid in L. L D L. D

45.2 Transferred to capital (Stock Dividend) L. D L. D L. D

45.3 Transferred from capital L. .1 D L D

46. Dividends to stockholders L L D L. D

47. Aggregate write-ins for gains or (losses) in surplus L D L D L ·(907)

48. Net change in capital & surplus (Lines 34 to 47) j. (3,675,173) L 5,094 ,735 L 1,931 ,648

49. Capital and surplus end of reporting period (Line 33 plus 48)


26,340,218 33,178,478 30,015,391

4701.

4702.

4703.

.......................................................................................................................................................................+ t D L ·(907)

.. 1- · ·t · · D L D

4798. Summary of remaining write-ins for Line 47 from overflow page L D L. D L. D

4799. Totals (Lines 4701 through 4703 plus 4798) (Line 47 above)

5

o o (907\


CASH FLOW1

Current YearTo Date

2Prior Year Ended

December 31

...................5,110 ,000

..................................0

..................................0

..................................0

..................................0

..................................0o

...................5,110,000

...................6,628 ,003

..................................0

..................................0

..................................0

..................................0__0

6,628 ,003o

(1,518,003)

Cash from Operations1. Premiums collected net of reinsurance................................................................................................................................................ . .72,711,317 .208,951,4432. Net investment income 216,828 1,841,1573. Miscellaneous income 0 0

4. Total (Lines 1 to 3) 72,928,145 210,792,6005. Benefits and loss related payments 52,787,411 174,414,8016. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts............................................................. . 07. Commissions, expenses paid and aggregate write-ins for deductions . 14,997, 160 41,090,5598. Dividends paid to policyholders 09. Federal and foreign income taxes paid (recovered) net of $ tax on capital gains (losses) (1 ,596,669) 11 ,418,028

10. Total (Lines 5 through 9) 66 ,187 ,902 226,923,38811. Net cash from operations (Line 4 minus Line 10) _................................... 6,740,243 (16 ,130 ,788)

Cash from Investments12. Proceeds from investments sold, matured or repaid:

12.1 Bonds 515 ,00012.2 Stocks 012.3 Mortgage loans 012.4 Real estate 012.5 Other invested assets 012.6 Net gains or (losses) on cash, cash equivalents and short-term investments 012.7 Miscellaneous proceeds 012.8 Total investment proceeds (Lines 12.1 to 12.7) 515,000

13. Cost of investments acqUired (long-term only):13.1 Bonds . 505,93613.2 Stocks 013.3 Mortgage loans 013.4 Real estate 013.5 Other invested assets 0

13.6 Miscellaneous applications 013.7 Total investments acquired (Lines 13.1 to 13.6) 505,936

14. Net increase (or decrease) in contract loans and premium notes 015. Net cash from investments (Line 12.8 minus Line 13.7 and Line 14) 9,064

Cash from Financing and Miscellaneous Sources16. Cash provided (applied):

16.1 SurplUS notes, capital notes 0 016.2 Capital and paid in surplus, less treasury stock. 0 016.3 Borrowed funds ............•................................................................................................................................................................ . 0 016.4 Net deposits on deposit-type contracts and other insurance liabilities . 0

~ ::~ ~~~~~~:~~~~~~~:~~;;i~d)::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. ··················i1··:2i·4:·3i~ ···················6·:489:·74~17. Net cash from financing and miscellaneous sources (Line 16.1 through Line 16.4 minus Line 16.5 plus Line 16.6) 11,214,315 6,489,745

RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) .5,534,992 (11 ,159 ,046)19. Cash, cash equivalents and short-term investments:

19.1 Beginning of year .22,860,164 34,019,21019.2 End of period (Line 18 plus Line 19.1) 28,395,156 22,860,164

6


EXHIBIT OF PREMIUMS, ENROLLMENT AND UTILIZATION

Total Members at end of:

1 I Comprehensive I 4 I 5 I 6 I 7(Hospital & Medical)

2 I 3 I Medicare I Vision I Dental I Federal EmployeesTotal I Individual Group Supplement Onlv Onlv Health Benefit Plan

8

Title XVIIIMedicare

9

Title XIXMedicaid

10

Other

:. :;:::~:::~;::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::1::::::::::::::::::::::: ::: ::~: :::::::::::::::::::::::::::::::::::~ .. :::::::::::::::::::::::::::::::::::~ .. :::::::::::::::::::::::::::::::::::~. :::::::::::::::::::::::::::::::::::~. :::::::::::::::::::::::::::::::::::~. :::::::::::::::::::::::::::::::::::~. :::::::::::::::::::::::::~.: :::: l:::::::::::::::::::::::::::::: ~:::::::::::::::::::::::::::::::::::~.

:. ~~:n~u~~:~~~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.:::::::::::::::::::::::::::::::::::~ :::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::r::::::::::::::::::::::::::::::::::::::[::::::::::::::::::::::::::::::::::::::5. Current Year

6 Current Year Member Months

••••••• u o +- +-•••••••••••••••••••••••••••••••••••••• +- ••••••••••••••••••••••••••••••••••••_.+- _._ __••••••••••••••••• 10••••••••••••••••••••••••••••••••••••••

.......................448, 929 ~ 1. t t t 1. 1. 35,759 L 413,170 .

...................................0

-.....I

Total Member Ambulatory Encounters for Period:

7. Physician 39,727 . 9,040 30,687

8. Non-Physician 9,744 .. 1,608 8, 136 .I I

9. Total 49,471 0 0 0 0 0 0 10 ,648 38 ,823

10. Hospital Patient Davs Incurred L 13,704 ~ L. t L. t 1 1 4,844 L 8,860

11. Number of Inpatient Admissions L. 3,633 1 1 1 L. 1 1 1. .777 L. .2 ,856

12. Health Premiums Written t· · 80 ,503, 952 ~ · · ··· ·..t · · + ·..··· ·t · · · ·..t· ·· ·..· t·· · ·..· ·..·· t ·30,468, 522 ~ 50,035, 430 ~· · ·..·· ·I

15. Health Premiums Earned .. 80,503,952 .. 30,468,522 50,035,430 .

16. Property/Casualty Premiums Earned 0 .. .

17. Amount Paid for Provision of Health Care Services .. 52,787,411 .. 18,608,151 34,179,260 .

18. Amountlncurred for Provision of Health Care Services 68,447,054 26,050,314 42,396,740

(a) For health premiums written: amount of Medicare Title XVIII exempt from state taxes or fees $ 30,468,522


CLAIMS UNPAID AND INCENTIVE POOL, WITHHOLD AND BONUS (Reported and Unreported)Aaln!1 Analysis of Unoaid Claims

1 I 2 I 3 I 4 I 5 I 6Account 1 - 30 Days 31 - 60 Days 61 - 90 Days 91 - 120 Days Over 120 Days

7Total

Claims Unpaid (Reported)

~~~e~~:~1n~fa~1~~~~~"ciiTid;:en"Hos'p'i'ia'C::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::1::::::::::::::::::::::::::::::i'oJ :1~~ t::::::::::::::::::::::::::::::::::::::::::::::t::::::::::::::::::::::::::::::::::::::::::::::1::::::::::::::::::::::::::::::::::::::::::::::1::::::::::::::::::::::::::::::::::::::::::::::t:::::::::::::::::::::::::::::3oJ:m

01999991ndividuaffv Listed Claims Unoaid- c-

110,468 0 -0 --

0 - 0 ---- -1I0,4680299999 Aooreoate Accounts Not Individuallv Listed-Uncovered 00399999 AQ!1regate Accounts Not Individuallv Listed-Covered 1,468,324 153,899 16,472 15,216 28,725 1,682,6360499999 Subtotals 1,578,792 153,899 16,472 15,216 28,725 1,793,104

(Xl0599999 Unreoorted Claims and Other Claim Reserves XXX XXX XXX XXX XXX 59,863,2080699999 Total Amounts Withheld XXX XXX XXX XXX XXX0799999 Total Claims Unoaid XXX XXX XXX XXX XXX 61,656,3120899999 Accrued Medical Incentive Pool and Bonus Amounts XXX XXX XXX XXX XXX


UNDERWRITING AND INVESTMENT EXHIBITANALYSIS OF CLAIMS UNPAID - PRIOR YEAR - NET OF REINSURANCE

ClaimsPaid Year to Date

2

LiabilityEnd of Current Quarter

3 , 45 6

Line of Business

OnClaims Incurred Prior

to January 1 ofCurrent Year

OnClaims IncurredDurina the Year

OnClaims Unpaid

Dec. 31of Prior Year

OnClaims IncurredDurino the Year

Claims Incurredin Prior Years

(Columns 1 + 3)

Estimated ClaimReserve and Claim

LiabilityDec. 31 ofPrior Year

1.

2.

3.

4.

5.

6.

<0 I7.

8.

9.

10.

11.

12.

Comprehensive (hospital & medical) L. 1.. 1.. 1.. 1.. .0 L.. D

Medicare Supplement.. J 1.. 1.. 1.. 1.. .0 L.. D

Dental Only L. 1.. 1.. 1.. 1.. .0 L.. D

Vision Only L. 1.. 1.. 1.. 1.. .0 L.. D

Federal Employees Health Benefits Plan L. 1.. 1.. 1.. 1.. .0 L.. D

Title XVIII- Medicare ~ 4,002 ,982 ~ 15 ,332 ,570 L. 11 ,036 ,708 ~ 9,591,657 L. 15 ,039 ,690 ~ 14,999 ,384

Title XIX-Medicaid L. 8,981 ,161 ~ 23,326,056 L. .23,548,409 ~ 17,479,538 L 32,529,570 L 32 ,641 ,859

Other Health L. 1.. 1.. 1.. 1.. .0 L.. D

Health SUbtotal (Lines 1 to 8) L. 12 ,984, 143 L. 38 ,658 ,626 L 34 ,585,117 L 27 ,071,195 L 47 ,569 ,260 ~ .47 ,641,243

Healthcare receivables (a) 1.. .1 1.. 1.. 1.. .0 L.. D

Other non-health L t t 1 1.. .0 L D

Medical incentive pools and bonus amounts L. l. 1 1.. 1 .0 L D

13. Totals

(a) Excludes $ loans and advances to providers not yet expensed.

12,984,143 38,658,626 34,585,117 27,071,195 47,569,260 47,641,243


NOTES TO FINANCIAL STATEMENTS

1. Summary of Significant Accounting Policies

The Company expanded its Medicare product to the states of Indiana and Missouri.

2. Accounting Changes and Correction of ErrorsNo significant change.

3. Business Combinations and GoodwillNo significant change.

4. Discontinued OperationsNo significant change.

5. InvestmentsNo significant change.

6. Joint Ventures, Partnerships and Limited Liability CompaniesNo significant change.

7. Investment IncomeNo significant change.

8. Derivative InstrumentsNo significant change.

9. Income TaxesNo significant change.

10. Information Concerning Parent, Subsidiaries, and AffiliatesNo significant change.

11. DebtNo significant change.

12. Retirement Plans, Deferred Compensation, Etc.No significant change.

13. Capital and Surplus, Shareholder' Dividend Restrictions and QuasiReorganizations.No significant change.

14. ContingenciesA. B. C. D. No significant change.

E. On October 24, 2007, certain federal and state agencies executed a search warrant at the headquarters ofWellCare Health Plans, Inc. ("WellCare") in Tampa, Florida. WellCare is the ultimate corporate parent of theCompany. The investigation, we understand, is being conducted by the U.S. Department of Justice, the U.S.Federal Bureau of Investigation, the U.S. Department of Health and Human Services Office of InspectorGeneral and the Florida Attorney General's Medicaid Fraud Control Unit. In addition, WellCare isresponding to requests for information from the Securities and Exchange Commission. WellCare is alsoresponding to subpoenas issued by the State of Connecticut Attorney General's Office involving transactionsbetween the Company and its affiliated companies and their potential impact on the costs of Connecticut'sMedicaid program. All of the foregoing inquiries and investigations are referred to herein as the"Investigations." WellCare is cooperating with the government agencies in connection with theInvestigations. To date, neither WellCare nor any of its subsidiaries, including the Company, have beenadvised by these federal and state agencies as to the full scope of the Investigations. Accordingly, thehistorical financial statements of the Company are necessarily subject to revision based upon the outcome ofthe Investigations. However, the U.S. Department of Justice said in a press release dated October 24, 2007,

10



that "[t]he ongoing investigation does not directly concern, nor should it have any impact upon, the deliveryof any health care service to any person."

A Special Committee of the Board of Directors of WellCare is conducting an independent investigation intomatters raised as part of the ongoing Investigations as well as other governmental or private party proceedingsthat may commence. The Special Committee's investigation includes, among other matters, an inquiry intointercompany transactions. WellCare and the Company are unable to predict when the Special Committeewill complete its work.

At this time, it is uncertain whether the outcome of the Investigations or the Special Committee'sinvestigation will result in a material impact on the Company's fmancial statements as of March 31,2008.

Putative class-action complaints were filed on October 26, 2007 and on November 2, 2007. These putativeclass actions, entitled Eastwood Enterprises, L.L.C. v. Farha, et aI. and Hutton v. WellCare Health Plans, Inc.,et aI., respectively, were filed in the United States District Court for the Middle District of Florida against theCompany, Todd Farha, the Company's former chairman and chief executive officer, and Paul Behrens, theCompany's former senior vice president and chief fmancial officer. Messrs. Farha and Behrens were alsoofficers of various subsidiaries of the Company. The Eastwood Enterprises complaint alleges that thedefendants materially misstated the Company's reported financial condition by, among other things,purportedly overstating revenue and understating expenses in amounts unspecified in the pleading in violationof the Securities Exchange Act of 1934, as amended. The Hutton complaint alleges that various publicstatements supposedly issued by defendants were materially misleading because they failed to disclose thatthe Company was purportedly operating its business in a potentially illegal and improper manner in violationof applicable federal guidelines and regulations. The complaint asserts claims under the Securities ExchangeAct of 1934, as amended. Both complaints seek, among other things, certification as a class action anddamages. The two actions were consolidated, and various parties and law firms filed motions seeking to bedesignated as Lead Plaintiff and Lead Counsel. In an Order issued on March 11, 2008, the Court appointed agroup of five public pension funds from New Mexico, Louisiana and Chicago (the "Public Pension FundGroup") as Lead Plaintiffs, and directed that those Lead Plaintiffs file a Consolidated Amended Complaint,which will become the operative pleading in the case, no later than May 12, 2008, to which the Defendantsmust respond within 60 days thereafter. The Company intends to vigorously defend itself against theseclaims. At this time, neither the Company nor any of its subsidiaries can predict the probable outcome ofthese claims. .

Five putative shareholder derivative actions were filed between October 29, 2007 and November 15, 2007.The first two of these putative shareholder derivative actions, entitled Rosky v. Farha, et al. and Rooney v.Farha, et aI., respectively, are supposedly brought on behalf of the Company and were filed in the UnitedStates District Court for the Middle District of Florida. Two additional actions, entitled IntermountainIronworkers Trust Fund v. Farha, et aI., and Myra Kahn Trust v. Farha, et al., were filed in Circuit Court forHillsborough County, Florida. All four of these actions are asserted against all Company directors (andformer director Todd Farha) except for D. Robert Graham, Heath Schiesser and Charles G. Berg and alsoname the Company as a nominal defendant. A fifth action, entitled Irvin v. Behrens, et aI., was filed in theUnited States District Court for the Middle District of Florida and asserts claims against all Companydirectors (and former director Todd Farha) except Heath Schiesser and Charles G. Berg and against twoformer Company officers, Paul Behrens and Thaddeus Bereday. All five actions contend, among other things,that the defendants allegedly allowed or caused the Company to misrepresent its reported fmancial results, inamounts unspecified in the pleadings, and seek damages and equitable relief for, among other things, thedefendants' supposed breach of fiduciary duty, waste and unjust enrichment. The three actions in federalcourt have been consolidated. Subsequent to that consolidation, an additional derivative complaint entitledCity of Philadelphia Board of Pensions and Retirement Fund v. Farha, et aI. was filed in the same federalcourt, but thereafter was consolidated into the existing consolidated action. A motion to consolidate the twostate court actions, to which all parties consented, was granted, and plaintiffs filed a consolidated complainton April 7, 2008. The Company intends to contest, among other things, the standing of the plaintiffs in eachof these derivative actions to prosecute the purported claims in the Company's name. At this time, neither theCompany nor any of its subsidiaries can predict the probable outcome ofthese claims.

15. LeasesNo significant change.

16. Information About Financial Instruments With Off-Balance Sheet RiskNo significant change.

10.1



17. Sale, Transfer and Servicing of Financial AssetsA. No significant change.B. No significant change.C. None.

18. Gain or Loss to the Reporting Entity From Uninsured Plans.No significant change.

19. Direct Premium Written by Managing General Agents.No significant change.

20. Other ItemsNo significant change.

21. Events SubsequentNo significant change.

22. Reinsurance.No significant change.

23. Retrospectively Rate ContractsNo significant change.

24. Change in Incurred Claims and Claim Adjustment ExpensesNo significant change.

25. Intercompany Pooling.No significant change.

26. Structured SettlementsNo significant change.

27. Health Care Receivables.No significant change.

28. Participating PoliciesNo significant change.

29. Premium Deficiency ReservesNo significant change.

30. Anticipated Salvage and Subrogation.No significant change.

10.2

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GENERAL INTERROGATORIES(Responses to these interrogatories should be based on changes that have occurred since the prior year end unless otherwise noted.)

PART 1 - COMMON INTERROGATORIESGENERAL

1.1 Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State ofDomicile, as required by the Model Act? ..

1.2 If yes, has the report been filed with the domiciliary state? .

2.1 Has any change been made during the year of this statement in the charter, by-laws, articles of incorporation, or deed of settlement of thereporting entity? .

2.2 If yes, date of change: .

If not previously filed, fumish herewith a certified copy of the instrument as amended.

3. Have there been any substantial changes in the organizational chart since the prior quarter end? ..

If yes, complete the Schedule Y - Part 1 - organizational chart.

4.1 Has the reporting entity been a party to a merger or consolidation during the period covered by this statement? .

4.2 If yes, provide the name of entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that hasceased to exist as a result of the merger or consolidation.

Yes [Xl No [ 1

Yes [Xl No [ 1

Yes [l No [Xl

Yes [l No [Xl

Yes [l No [Xl

1Name of Enti

3State of Domicile

12/31/2005

5. If the reporting entity is sUbject to a management agreement, including third-party administrator(s), managing general agent(s), attomey-in-fac~ or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? Yes [l No [X1 NA [ 1If yes, attach an explanation.

6.1 State as of what date the latest financial examination of the reporting entity was made or is being made. 12/31/2005

6.2 State the as of date that the latest financial examination report became available from either the state of domicile or the reporting entity. Thisdate should be the date of the examined balance sheet and not the date the report was completed or released ..

6.3 State as of what date the latest financial examination report became available to other states or the pUblic from either the state of domicile orthe reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheetdate) .

6.4 By what department or departments?

III inols Department of Insurance .

6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financialstatement filed with Departments? ..

6.6 Have all of the recommendations within the latest financial examination report been complied with? .

7.1 Has this reporting entity had any Certificates of Authority, licenses or registrations (inclUding corporate registration, if applicable) suspendedor revoked by any governmental entity during the reporting period? .

7.2 If yes, give fUll information:

8.1 Is the company a subsidiary of a bank holding company regulated by the Federal Reserve Board? .

8.2 If response to 8.1 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 afederal regulatory services agency ~.e. the Federal Reserve Board (FRB), the Office of the Comptroller of the Currency (OCC), the Office ofThrift Supervision (OTS), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identifythe affiliate's primary federal regulator.]

01/23/2007

Yes [X1 No [l NA [ 1

Yes [X1 No [l NA [ 1

Yes [l No [Xl

Yes [l No [Xl

Yes [l No [Xl

1 2 3 4 5 6 7Location

Affiliate Name ICitv, Statel FRB OCC OTS FDIC SEC

11


GENERAL INTERROGATORIES

9.1 Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performingsimilar 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 professionalrelationships;

(b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity;

(c) Compliance with applicable govemmentallaws, rules and regUlations;

(d) The prompt intemal reporting of violations to an appropriate person or persons identified in the code; and

(e) Accountability for adherence to the code.

9.11 If the response to 9.1 is No, please explain:

9.2 Has the code of ethics for senior managers been amended? .

9.21 If the response to 9.2 is Yes, provide information related to amendment(s).

9.3 Have any provisions of the code of ethics been waived for any of the specified officers? .

9.31 If the response to 9.3 is Yes, provide the nature of any waiver(s).

FINANCIAL

Yes [Xl No [ ]

Yes [] No [X]

Yes [l No [X]

10.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement?........................................... Yes [] No [X110.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount $ D

INVESTMENT11.1 Were any of the stocks, bonds, or other assets of the reporting entity loaned, placed under option agreement, or otherwise made available

for use by another person? (ExclUde securities under securities lending agreements.) .

11.2 If yes, give full and complete information relating thereto:

Yes [] No [Xl

12. Amount of real estate and mortgages held in other invested assets in Schedule BA: $ 0

13. Amount of real estate and mortgages held in short-term investments: '1> ...............................................0

14.1 Does the reporting entity have any investments in parent, subsidiaries and affiliates? ..

14.2 If yes, please complete the follOWing:

Yes [] No [X]

14.21 Bonds .14.22 Preferred Stock .14.23 Common Stock ..14.24 Short-Term Investments .14.25 Mortgage Loans on Real Estate ..14.26 All Other .14.27 Total Investment in Parent, Subsidiaries and Affiliates (Subtotal

Lines 14.21 to 14.26) .14.28 Total Investment in Parent inclUded in Lines 14.21 to 14.26 above ..

1Prior Year-EndBook/AdjustedCarrying Value

$$$$$$

$ D$

2Current QuarterBook/AdjustedCarrying Value

$$$$$$

$ D$

15.1 Has the reporting entity entered into any hedging transactions reported on Schedule DB? .

15.2 If yes, has a comprehensive description of the hedging program been made available to the domiciliary state? .If no, attach a description with this statement.

11.1

Yes [l No [X]

Yes [l No [ ]


GENERAL INTERROGATORIES16. Excluding items in Schedule E. reai estate. mortgage loans and investments held physically in the reporting entity's offices. vaults or safety

deposit boxes. were all stocks. bonds and other securities. owned throughout the current year held pursuant to a custodial agreement with aqualified bank or trust company in accordance with Section 3. III Conducting Examinations. G - Custodial or Safekeeping Agreements of theNAIC Financial Condition Examiners Handbook? .

16.1 For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook. complete the following:

1 I 2Name of Custodian(sl Custodian Address

JP Morgan Chase IChicago. III inois .

16.2 For all agreements that do not comply with the requirements of the NAIC Financial Condition Examiners Handbook. provide the name.location and a complete explanation:

2Location(s

16.3 Have there been any changes. including name changes in the custodian(s) identified in 16.1 during the current quarter? .

16.4 If yes. give full and complete information relating thereto:

Yes [X] No [ ]

Yes [] No [X]

1Old Custodian

2New Custodian

4Reason

16.5 Identify all investment advisors. brokers/dealers or individuals acting on behalf of broker/dealers that have access to the investmentaccounts. handle securities and have authority to make investments on behalf of the reporting entity:

3Address

17.1 Have all the filing requirements of the Purposes and Procedures Manua/ of the NAIC Securities Valuation Office been followed? .

17.2 If no. list exceptions:

11.2

Yes [X] No [ ]


SCHEDULE S - CEDED REINSURANCEShowing All New Reinsurance Treaties· Current Year to Date

1NAIC

CompanyCode

2Federal

IDNumber

3

EffectiveDate

4

Name ofReinsurer

ACCIDENT AND HEALTH AFFILIATES

5

Location

6

Type ofReinsurance Ceded

7Is Insurer

Authorized?(Yes or No)

......N

ACCIDENT AND HEALTH NON·AFFILIATES..............39845 + .48.0921045 + 01/01/2008 !Ylestport Insurance Corp /Overland Park, KS. ~ SSl/I/A... t yes .

LIFE AND ANNUITY AFFILIATESLIFE AND ANNUITY NON·AFFILIATESPROPERTY/CASUALTY AFFILIATESPROPERTY/CASUALTY NON·AFFILIATES

.~•••••••••••••••••••••••••••••••••• u u.ow u _ I _.•••••.•......•••••••....•...••.•..__ _._ _ __ .


SCHEDULE T - PREMIUMS AND OTHER CONSIDERATIONSCurrent Year to Date - Allocated by States and Territories

Direct Business Only9

Deposit-TypeContracts

87432 5 6Federal

Employees Life & AnnuityAccident & I I IHealth Benefit Premiums & I Propertyl I Total

Active Health Medicare Medicaid Program Other Casualty ColumnsStates, Etc, I Status I Premiums Title XVIII Title XIX Premiums Considerations Premiums 2 ThrouQh 7

o

.....................0

.....................0

1. Alabama AL . 0 .

2. Alaska AK . 0 .

3. Arizona AZ . 0 .

4. Arkansas AR . 0 .

5. California CA 0 .

6. Colorado CO . 0 .

7. Connecticut c•••••.•....CT 0 .

8. Delaware DE 0 .

9. District of Columbia DC 0 .

10. Florida FL . 0 .

11. Georgia GA 0 .

12. Hawaii HI 0 .13. Idaho 10 0 .

14. lIIinois IL 1. 26.974,331 .41,835.421 68.809.752 .15. Indiana IN 1. .2,065.541 24,071 2.089,612 .16. Iowa IA 0 .

17. Kansas KS 0 .

18. Kentucky KY . 0 .

19. Louisiana LA 0 .

20. Maine ME . 0 .

21. Maryland MD . 0 .

22. Mas.sachusetts MA . 0 .

23. Michigan MI . 0 .

24. Minnesota MN . 0 .

25. Mississippi MS . 0 .

26. Missouri MO 1. 1.428,651 8.175.937 9.604,588 .27. Montana MT . 0 .

28. Nebraska NE . 0 .

29. Nevada NV 0 .30. New Hampshire NH 0 .

31. New Jersey NJ 0 .

32. New Mexico NM . 0 .

33. New York Ny 0 .

34. North Carolina NC . 0 .

35. North Dakota NO . 0 .

36. Ohio OH 0 .

37. Oklahoma OK 0 .

38. Oregon OR . 0 .

39. Pennsylvania PA 0 .

40. Rhode Island RI 0 .

41. South Carolina SC . 0 .

42. South Dakota SO 0 .

43. Tennessee TN 0 .

44. Texas TX 0 .

45. Utah UT 0 .

46. Vermont VT . 0 .

47. Virginia VA 0 .

48. Washington WA . 0 .

49. WestVirginia WV 0 .

50. Wisconsin Wi 0 .

51. Wyoming WY 0 .

52. American Samoa AS 0 .

53. Guam GU 0 .

54. Puerto Rico PR ..........•....................................................................................................................................................................................0 .

55. U.S. Virgin Islands Vi 0 .

56. Northern Mariana Islands MP 0 .

57. Canada CN 0 .

58. Aggregate Other Alien OT .xXX 0 0 0 0· 0 0 0

59. SubtotaL .xXX 0 30,468.523 50.035,429 0 0 0 80,503.95260. Reporting entity contributions for

61. ~:~II~~~::e;::i~:~:~s c:;····.xXX···3··· ·····················0·· ····30:·46"B":S23··t····SO·:03·S·:429··t·····················o..t·····················o..t···················..o··t····8o·:sci"3:9S~ ~·························I


::::::::::::::::::l:_:f±t:::::l:-::[:::=:£::::_:]::=::l::::£:_:::1::::].....................0 L. OL. OL. OL. OL. OL. O

5898. Summary of remaining write-ins forLine 58 from overflow page L .xXX L O

5899. Totals (Lines 5801 through 5803plus 5898) (Line 58 above) I XXX I 0 o o o o o o o

(a) Insert the number of L responses except for Canada and other Alien.

13


SCHEDULE Y -INFORMATION CONCERNING ACTIVITIES OF INSURER MEMBERS OF A HOLDING COMPANY GROUPPART 1 - ORGANIZATIONAL CHART

WellCare® The WeliCare Group of Companies(as of March 31, 2008)

~

~

Shapes/colors distinguish among HMOs, LLCs, regulated Insurance companies and corporaUons.

STATEMENT AS OF MARCH 31,2008 OF THE Harmony Health Plan of Illinois, Inc.

SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIESThe following supplemental reports are required to be filed as part of your statement filing. However, in the event that your company does not transact the type of businessfor which the special report must be filed, your response of NO to the specific interrogatory will be accepted in lieu of filing a 'NONE' report and a bar code will be printed below.If the supplemental is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatoryquestions.

RESPONSE

1. Will the Medicare Part D Coverage Statement be filed with the state of domicile and the NAIC with this statement?

Explanation:

1.Medicare Part 0 stand alone business not written by the Company.

BarCode:

1. 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 122 9 2 0 0 836 5 0 0 0 0 1

15

___._._. NO _


OVERFLOW PAGE FOR WRITE...INS

MQ002 Additional Aggregate Lines for Page 02 Line 23."ASSETS

2

NonadmittedAssets I Assets

;;~i:~~~~~~~~~~~;~~~~el~~=i~~'f~;'Li'~;'23'f;~';;;'P;~~'oz································ F················~ :~~~ :~~~ ~ ~ :~~~ :~~~

16

3Net Admitted

Assets(Cols. 1 - 2)

......••••••............•••••••••.Do

4

Prior Year NetAdmitted Assets

..••••••••.........••••.••.•......Do


SCHEDULE A - VERIFICATIONReal Estate

2Prior Year Ended

December 31

............................................DYear to Date

1. Book/adjusted carrying value, December 31 of prior year 2 L D2. Cost of acquired:

2.1 Actual cost at time of acquisitions :::: = =: :::: = = 1

~: ~~t~~trJ~~~~fi;~:~p~~~:.~~~~~~.~::~~~:~:~i.~~~::::::::::::::::~:::::::::::::~::~:..:::::::::::::~:::::::::::::::::::::::::::::::::::::~::::.::::::: :::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::~::5. Deduct amounts received on disposals............................................................................................................................ . 06. Total foreign exchange change in book/adjusted carrying value 0

~: g:~~~~ ~~~:~~ ~::~: ~~h::e~~:;o~~:.~~~~.~~:.~~~.~.~~:.~~.~.~.~.~~~~~·.~~~·:.·.~.: : ~.:::.~.:..::.~..~..~..~..~.:..: ~.:..:..:..:.~..~ :..:::::::::..: ~:..:..:..: :::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::19. Book/adjusted carrying value at the end of current period (Lines 1+2+3+4-5+6-7-8) 0 0

10. Deduct total nonadmitted amount.................................................................................................................................... . 011. Statement value at end of current period (Line 9 minus Line 10\ 0 0

SCHEDULE B - VERIFICATIONMortQaQe Loans

2Prior Year Ended

Year to Date I December 31

1. Book value/recorded investment excluding accrued interesftlborN" , D D

2. ;.~st ~~~~i~~~~:at time of acquisitions I ~.... '" . D2.2 Additional investment made after acquisitions . D

1~§1~?~~~;~~~~~~~=~~::~=:::~~~~=~:_-~~=~:~~~:~:~;~~~-~~~_:::-~~:_:~:-;~::~; ~::::;:~:::::-;~::=~I7. Deduct amounts received on disposals 08. Deduct amortization of premium and mortgage interest points and commitment fees............................................... . 19. Total foreign exchange change in book value/recorded investment excluding accrued interest............................... . .

10. Deduct current year's other than temporary impairment recognized............................................................................. . 011. Book value/recorded investment excluding accrued interest at end of current period (Lines 1+2+3+4+5+6-7-

8+9-1 0)................................................................................................................................................................................ . 0 D12. Deduct total nonadmitted accounts................................................................................................................................... . D13. Statement value at end of current period (Line 11 minus Line 12\ 0 0

SCHEDULE BA - VERIFICATIONOther LonQ Term Invested Assets

2Prior Year Ended


1. Book/adjusted carrying value, December 31 of prior year -ft.:•..•.........I ..-ft.:•...I- D 0

2. ;.~st ~~~~i~~~:at time of acquisitions I ~ '-I- I ~ &-- D2.2 Additional investment made after acquisitions . 0

~: ;~~~~~:Z:rdd~~~~~t~~:~~~~:.~~~.~~.~~~~~~~:~~~~~~~:~:~~~~~~~:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~::~~~~~~~~~~~~~~~~~:~~~:~~~~~~~~~~~~~~~~~~~:~~~:~~~~~~~~~ :::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::0"~: ~~;:a;~~d(~~~~~~nd:~~~~~~:'.~~~~~.~~~~~:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::0'"7. Deduct amounts received on disposals D8. Deduct amortization of premium and depreciation.......................................................................................................... . D9. Total foreign exchange change in book/adjusted carrying value 0

10. Deduct current year's other than temporary impairment recognized J11. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5+6-7-8+9-1 0) D D12. Deduct total nonadmitted amounts D13. Statement value at end of current period (Line 11 minus Line 12\ 0 0

SCHEDULE D - VERIFICATIONBonds and Stocks

2Prior Year Ended


1. Book/adjusted carrying vaiue of bonds and stocks, December 31 of prior year . 6. 141 .906 4.600.0002. Cost of bonds and stocks acquired 505, 936 6.628.0033. Accrual of discount............................................................................................................................................................ . 1.668 .25 ,2134. Unrealized valuation increase (decrease) D5. Total gain (loss) on disposals 06. Deduct consideration for bonds and stocks disposed oL 515 .000 5,110,0007. Deduct amortization of premium 310 1.3108. Total foreign exchange change in book/adjusted carrying value D9. Deduct current year's other than temporary impairment recognized /

10. Book/adjusted carrying value at end of current period (Lines 1+2+3+4+5-6-7+8-9) 6,134 ,200 6.141.90611. Deduct total nonadmitted amounts................................................................................................................................... ..: 012. Statement value at end of current eriod Line 10 minus Line 11 6.134.200 6.141,906

8101


SCHEDULE D - PART 18Showing the Acquisitions, Dispositions and Non-Trading Activity

DurlnCl the Current Quarter for all Bonds and Preferred Stock bv RatinQ Class

8Book/AdjustedCarrying ValueDecember 31

Prior Year

7Book/AdjustedCarrying Value

End ofThird Quarter


End ofSecond Quarter


End ofFirst Quarter

DispositionsDuring

Current Quarter

2 I 3 I 4Non-Trading

ActivityDuring

Current Quarter

AcquisitionsDuring

Current Quarter


Beginning ofCurrent Quarter

BONDS

1. Class 1 (a) .6,141,906 505,936 515,000 1,358 .6,134,200 0

2. Class 2 (a) 0 0 0

3. Class 3 (a)........................................................................................... .. 0 0 0

4. Class 4 (a)........................................................................................... .. 0 0 0

5. Class 5 (a) 0 0 0

6. Class 6 (a) 0 0 0

...........................................0

...........................................0

...........................................0

...........................................0

...........................................0

o

............................6, 141,906

...........................................0

...........................................0

...........................................0

...........................................0

o7. Total Bonds 6,141,906 505,936 515,000 1,358 6,134,200 o o 6,141,906

(J)

oN PREFERRED STOCK

8. Class 1 0 0 0 0 0

9. Class 2 0 0 0 0 0

10. Class 3 0 0 0 0 0

11. Class 4 0 0 0 0 0

12. Class 5 0 0 0 0 0

13. Class 6 0 0 0 0 0

14. Total Preferred Stock 0 0 0 0 0 0 0 0

15. Total Bonds and Preferred Stock 6,141,906 505,936 515,000 1,358 6,134,200 0 0 6,141,906

(a) Book/Adjusted Carrying Value column for the end of the current reporting period includes the following amount of non-rated short-term and cash equivalent bonds by NAIC designation: NAIC 1 $ ; NAIC 2 $ ; NAIC 3 $ ;NAIC 4 $ ; NAIC 5 $ ; NAIC 6 $ .


Schedule DA - Part 1

NONESchedule DA - Verification

NONESchedule DB - Part F - Section 1

NONESchedule DB - Part F - Section 2

NONESchedule E Verification

NONESchedule A - Part 2

NONESchedule A - Part 3

NONESchedule B - Part 2

NONE·Schedule B - Part 3

NONESchedule BA - Part 2

NONESchedule BA - Part 3

NONE

8103, 8104, 8105, 8106, E01, E02, E03


SCHEDULE D - PART 3Show All LonQ-Term Bonds and Stock Acauired Durina the Current Quarter

Inc L. .1 50!r.-935

Number of I ActualName of Vendor I Shares of Stock Cost

mo,.J:::..

2

CUSIPIdentification I Description

........912195·G2·L IU.S:··T·Bi II ..0399999 • Total· BOllds • U.S. Government6099997 • Total • Bonds· Part 36099999 • Tola I . Bonds6599999 • Tolal • Preferred Slacks7299999 '. Tolal • Common Slacks7399999 • Total • Preferred and Common Stocks

7499999· Totals

3

Foreilln

4 I 5 I 6

Date Acauired.......b2126f2bbB...~::Jj.P. MorQall secur!t ies.

7

505.936505.936505.936

ooo

505.936

8

Par Value.............................515.000

515.000515.000515.000

xxxxxxxxx

xxx

9

Paid for AccruedInterest and Dividends

................................4.5324.5324.5324.532

ooo

4.532

10NAIC

Designation orMarket

Indicator (aj

xxxxxxxxxxxxxxxxxx

xxx(a) For all common stock bearing the NAIC market indicator "U" provide: the number of such issues .


SCHEDULE D - PART 4Show All Lonq-Term Bonds and Stock Sold. Redeemed or Otherwise Disposed of bv the Company Durinq the Current Quarter

2 3 4 5 6 7 I 8 I 9 I 10 I Change in Book/Adjusted Carrying Value I 16i i

17 18 19 20 21 22

11 12 13 14 15

912195~C4; Cru:s:-r;Si I L __...:.:.m.m..I._.LOl/241200a.1 MarkeL...•..... __m.....:::::::::I::::::::==::::::::__L....:::::515,000

Far

CUSIP I I~I I INumber ofIdenti- g Disposal Shares offication Description n Date Name of Purchaser Stock IConsideration

515,000 515,000 503,023 015,000515,000 515,000 503,023 515,000515,000 515,000 503,023 515,000

0 XXX 0 00 XXX 0 00 XXX 0 0

XXX" XXXXXX XXX

0 0 XXX XXX0 0 XXX XXX0 0 XXX XXX01 01 XXX XXX

NAICDesignation

orMarket

Maturity IIndicatorDate fa)

..01/24)200a._•.•.•.......•.

BondInteresUStock

DividendsReceived

Durina Year.............•••••.•.0

Total Gain(Loss) onDisposal

....•.•..............0

......•..............0

Realized Gain(Loss) onDisposal

...•...........•.....0.........•.•.........0

ForeignExchange Gain

(Loss) onDisposal

515":000

515-:000515-:000

Book/Adjusted

Carrying Valueat

Disposal Date_..•........515,000

Total ForeignExchangeChange inB.lAC.V.

.......•..•.•........0

Current Year'sOlherThan

Current Year's ITemP.orary ITotal Change in(Amortization)1 Impairment B.lA.C.V.

Accretion Recoanized f11 +12 - 13\

:::::::::::::::::::::~l:::::::::::::::::::~I:::::::::::::::::J

UnrealizedValuationIncreasel

(Decrease)....•.........•.•....0.......••515;000

Prior YearBook/Adjusted

CarryingValuePar Value I Actual Cost

.mm..5f5~ooo r 503,023

0399999 - Bonds"· UrGovernments6099"997 - Bonds - ParT"4

7299999 - rota-I - Common Slocks

6099999 - Tot aI - BOIids

7399999 - ToTal - piBfeired and Common Slocks

6599999 - Tolar - Preferred Slacks

moCJ1

7499999 Totals 515,000 XXX 503,023 515,000 515,000 XXX XXX(a) For all common stock bearing the NAIC market indicalor "U" provide: the number of such issues


Schedule DB - Part A - Section 1

NONESchedule DB - Part B - Section 1

NONESchedule DB - Part C - Section 1

NONESchedule DB - Part 0 - Section 1

NONE

E06, EO?


SCHEDULE E - PART 1 - CASHMonth End Depositorv Balances

2 I 3 I 4 5 Book Balance at End of EachMonth During Current Quarter

9

Amount ofInterest

ReceivedRate I During

of CurrentDepository I Code I Interest Quarter

JP Morean Chase.....•.•.•.•.•...........•.•.••..............! I I inois....•.•.•............••••..•..L 1.. 1.. 180.9150199998 Deposi Is in .•.•.•.............•.•.•........ deposi lories thai do

not exceed Ihe allowable I imi I in anyone deposi lory(see Instructions) • Open Deoositories I XXX 1 XXX

0199999 Totals· Open Deposi lories I XXX I XXX I 180.915

Amount ofInterest

Accrued atCurrent

StatementDate

6 I 7 1 8

First Month Second Month Third Month..•.....34 .446.480 •...•.....35.029.460 ..•.•.•28.395.156 XXX

XXX34.446.480 35.029.460 28.395.156 XXX

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I····················································· _ j- j- + j- j- j- + ~

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0399999 ToIaI Cash on Depos i IiJ499999 Cashin ComPiinv'sOff ice

0599999 Total Cash

XXXXXXXXX

XXXXXXXXX

E08

180.915xxx

180.915xxx

34.446.480

34.446.480

35;iJ29.460

35.029.460

28.395.156IXXXXXX

28.395.156IXXX


Schedule E - Part 2 - Cash Equivalents

NONEMedicare Part D Coverage: Supplement

NONE

E09,365

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Harmony Health Plan of Illinois, Inc. - IIS Windows Serverlibrary.corporate-ir.net/library/17/176/176521/items/294084/1Q2008... · HEALTH QUARTERLY STATEMENT OFTHE Harmony Health