Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 1 of 55
Defendant's Exhibit # 5
B-63
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 2 of 55
655 FIFTEENTH STREET, N.W.. SUITE 900
. MILLER & CHEVALIER
CHAATEAEO
WASHINGTON, D.C. 20005-5701 202.626.5800 FAX, 202.628.0858 WWW.MILLERCHEVALIER.COM
ADAM P. FEINBERG
202.626.6087
afelnbergCmllchev.com
September 22, 2006
VIA FIRST CLASS MAIL AND E- MAIL
Karen E. Servidea, Esquire U.S. Department of Justice Federal Claims Section -- Tax Division Court of Ben Franklin Post Office Post Office Box 26 Washington, D.C. 20044
Re: Hospital Services Assoc, olN.E, Penn. v. United States; Federal Claims No. 05-503 T U.S. Court of
Dear Ms. Servidea:
We wrte in response to your September 11, 2006, letter regarding Plaintiff s responses to your second set of interrogatories and second set of requests for admission.
1. With respect to Interrogatories i 4 and i 5, we have collected documentation
describing how Plaintiff sets its premium rates for group health insurance subscribers durg the
relevant time period, and these documents ar curntly available for your review and copyig. As we previously discussed on the telephone, Interrgatory 22 is substatially harder to deal with because, among other reasons, it would require a complex analysis and even then the anwer would likely be an
estiate. In addition, the inormation sought does not appe to be relevant to ths case.l In any event,
we have collected some, but not all, potentially relevant documents. These documents are also
curently available for your review and copyig. Before producing additiona respnsive documents, we ask that you clarfy the inormation you ar seeking and explai how it is relevant to ths case. In our telephone discussions, you explained tht you were not interested in a precise dollar anwer, but rather oruy wanted to know the general categories of costs that Plaintiff incured between 1987 and 1997 in creating, or facilitatig the creation of, heathcare coverage contrcts. Plaitiff is able to answer that question without reference to the documents. These categories include advertising,
salares (and related expenses), trvel, equipment, supplies, priting and stationar, and
postage/telephone.
i In par for these rens, Plaintiff objected to this Interrgatory as being vague, unduly burdensome, and not reasonably
calculated to lead to the discovery of
admissible evidence.
r:0U , .)--i-..V-c.c4. -.L- .- (f JT:2fC
/) ,J ..
WASHINGTON
B-64
PHILADELPHIA
Case 1:05-cv-00503-TCW
Karen E. Servidea, Esquire September 22, 2006
Page 2
Document 30-3
Filed 02/28/2007
Page 3 of 55
2. Lee Russell, John O'Conner, Clifford Jones, Bruce Darkes, Lee Holt, and Mike
Shields were Ernst & Young employees. Bruce Darkes' curent contact information can be believes that Clifford Jones is retired, but it does found in Plaintiffs initial disclosures. Plaintiff not have any current contact information. Plaintiff believes the remaining individuals are stil them, including Lee Russell, can be contacted at Ernst & Young employees. At least some of Ernst & Young's Philadelphia office: Two Commerce Square, Suite 4000, 2001 Market Street, Philadelphia, Pennsylvania 19103; (215) 448-5099. As you know from Plaintiff s initial disclosures, Peter Wood is Plaintiffs Director - Tax. His contact information is shown in the initial disclosures. As you know from Plaintiff prior interrogatory responses, David Bobonski was formerly Plaintiffs tax manager. Plaintiff does not have any curent contact information. Mielcarek, and Mar Rosner were IRS employees. As you may also know, John Gorman, Dave.
Suzane Fletcher, Charies Morgan, Joan Pctchal-Metcalf, and James Wilson were Parente
Randolph LLC employees. Suzane Fletcher is now Plaintiffs Vice President - Finance. Charles Morgan and James Wilson may be contacted at Parente Randolph LLC, 46 Public Square, Wilkes-Barre, Pennsylvania 18701; (570) 820-0100. Joan Petchal-Metcalfis now with Gattuso Group LLC, Cross Valley Center, Suite 207, 667 North River Street, Plains,
Pennsylvania 18705; (570) 706-2610.
3. We disagree with your assertion that Requests for Admission 29 and 30 can be
admitted or denied without assuming that a change in method of accounting took place. In any event, to the extent that these requests for admission can be read as you suggest, Plaintiff admits the IRS to change its method of accounting tor the that it did not secure the consent of care coverage contracts between the time it fied its original health lenni nation or cancellation of
tax returs for the 1987 through 1995 tax years and the time it filed its refud claims for the
1992 through 1995 tax years or between the time it fied its original tax returs for the 1987 through 1995 tax years and the time it filed its original income tax returns for the 1996 and 1997
tax years.
denied Request for Admissions 35(l) and (2) and 36(1) and (2) because it believes its records contain this information. Specifically, Plaintiffs systems capture claims information (on both a subscriber-specific and participant-specific basis) and subscriber paymen1 history. With respect Lo Request 36(1), Plaintiff considers a paricipant's claims daia may also have additional information health problems." Plaintiff to also qualify as a "history of health problems. Plaintiff denied Request 38(2) and (3) regarding participants' histories of because that information was considered by Ernst & Young in its valuation report. You should now have Ernst & Young's report and work papers, which should explain how that information
4. Plaintiff
was used. In general terms, each participant's claims experience (and accordingly their history
health problems) was inherently used by Ernst & Young in that it used actul data on premiums, which is based on all paricipants' claims experience. To answer the specific question in your letter, we did not mean to suggest that Ernst & Young directly used each participant's claims experience to calculate the fair market value of each healthcare coverage contract. Plaintiff denied Request 41 (2) because claims data for all participants is used to set premium rates. For experience-rated products, each participant's claims data are used to set the
of
B-65
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 4 of 55
Karen E. Servidea, Esquire
September 22, 2006
Page 3
specific rate for their group subscriber. Each participant's claims data are also used to set rates for community-rated subscribers, although claims data for others is also used in that process. health problems may also be considered in a When relevant, a paricular paricipant's history of less formulaic maner.
the concerns raised in your letter. Ifnot, please let us know and we would happy to discuss these issues with you fuher. Also, pleae contact us at your convenience to make argements to review and/or copy the documents tht ar curently
We hope this addresses all of
available.
Sincerely,
¿: ~- ..~ Adam P. Feinberg
B-66
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 5 of 55
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 6 of 55
Defendant's Exhibit # 6
B-68
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 7 of 55
f
P.NN.YLVANIA
I' U
t
"
ANNUAL STATEMENT
0.. ,.
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COMMONWIlLTH OF ...NNSVLVANIA
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¡
1991
i
NEPAOO78
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 8 of 55
F.. IJ
HOSPIAL. MlCA AN DENAL II OfIND CORIIIlTINI
ANNUAL STATEMENT
For th Year Ened Decmb 31, 1991 ~ ,: ~ !.~l' /í.~ú.~,,~ 4"'-~7 . ¿,. - /:.uu: .7''__ d -' ......~
OF THI! CONOmON AND UFAlRS OF THE
7 NAIC Group Coeg4NAIC Company Cod~-~ 7i1
Emplyer's 10 Numbe~-¿i", Iff /77
. mee to the
t
Orgized under the La of the Sta of rh.. -~ ..~
I
INSURACE COMMIONER OF TH COMßTH If PENVANIA
I' TO 1M. U.ft1M-iOF
Incorat ~j'_o.-./~.."J' j'~' Cormnced Business ~ /. /9~J'
Staory Home Offce -:4 A. ~ ~ ,èb~ - &- ~ /'71/
Man Adinis Of 7t J1,ø ;;.u ~
¿,.J~',~~ - ~ c:# /1,7// (717) 1,;.9-(,411 Mail Adress ~~ h~ M-' ~ ,7.~',~. ¿. ,:i //7//
Primar Locon of BookS an Record ~~ ;;~ ~~ ..",'"
?.¿d~"~J. ~ :../í11.f711 (717) .I.;9-~iJl/
Annual Stateme Cont Person and Phone NumberØ./..~ ~~ (717) ,I,:9-G.tJ/l'
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NEPAOO79
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 9 of 55
JOHN RARACK, A.C.A.S., M.A..A.A.
CONSUG ACY
.
I
2429 Prospet Avenue I ~vanston. Ilinois 6001
Januar 31, 1992
Phone (708) 328-5374
The Honorable Constace B. Foste
Insurce Cossoner
Strawberr Squar
13th Floor
Pennsylvania Insurce Deparent
Harsburg, Pennsylvania 17120
Dear Commssoner:
I, John Harack, Consulting Actl. am a member Qrth Amerca Academy of Actuares and
have been retaned by Hospita Servce Asation of 1088 reserves. actuaral
Norteastern Pensylvana with regar to
the corpration as
liabilties. and related ite.
I have examned the asptions and method usd in determng los rees, actaral
liabilties. and related items listed below as shown in the anual statet or prepared for filing with state regulatory offcial as of
Deber 31, 1991:
1) Claim unpaid (Page 3, Ite 1) $113,875.411
2) Unpaid Claims adjustent expenses (Page 3. Item 3) $2,410,102
My exanation included such review of
the asumptions and method us and orthe underlying
the ite identified above
basic records and snmmares and such tests and calculations as I consdered necess.
In my opinion, the amunts caed in the balance sheet on account of
ar in 'accrdance with accpte acuaal stadar consstetly applied and faily stated in
accordance with sound actal principles, ar basd on actuaral asptions relevant to
contrct provisions and ap~priate to the purpse for which the Stateent was prepar, meet the
requireents of the laws of the Commonwealth of Pen nay Iv ani
a and mae go and sucient
provisions for all unpaid claims and other actuaral
liabilties under the te ofits contracts and
agrements, ar computed on the bass of asumptions consitet with thos usd in coluting the
correStnding ite in the anual stateent of
provi81on for all actuaral ite which ought to be esblished.
Sincerely, J / i
"..~. " /~./ ,"
ßøhn Harack
JH:llp
1~
Decber 31, 1990, and include appropnate
B-71
NEPAQ0
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 10 of 55
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Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 11 of 55
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NEPA002
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 12 of 55
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NEPA003
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 13 of 55
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NEPAOOOO
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 14 of 55
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Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 15 of 55
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B-77
NEPAOO
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 16 of 55
Defendant's Exhibit # 7
B-78
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 17 of 55
PIINSYLVANIA
_u
.
..
ANNUAL STATEMENT
0.. TH.
J¡'~-¡'/~7:W I(~~~
ly ~Ou~-- æ~7¿rd-KL~J
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In Il- .. 01
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Insurance Commissioner
OP TN.
COMMONWEALTH 011 ...NNSVLVANIA
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B-79
NEPAOO
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 18 of 55
1lAL IlAND DEIIOR i- CO f& 13
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ANNUAL STATEMENT
For th Year Ende Deermr 31, 1992
Of'1 CO N# I\AS OF
THE
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In ~.1'. 1'13' COen Bii ,o-_-.~ ,-:I, 1P.5,
NA Gr Co N4 NA Co Co 51.,.,7 Ems Ð Num ..,..,~d/?7
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B-80
NEPA0095
II
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Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 19 of 55
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JOHN HARCK, A.C.A.S., M.A.A.A. CONSU"iG ACTY
I
. :429 Pr Aveue I
InstOD, Ilinois 6001
Phone (708) 328-5374
i January 29,1993
The Honorable C~nthia M. Maleski
Insuraice Conuiøioner
. Strwberry Square Harsburg, Pennsylvana i 7120
Pennsylvania Insurance Deparent 13th Floor
Dear Commissioner:
I, John Harack, Consulting Actuar, am a member of the America Academy of Actuaries and
have ben retaned by Hospital Service Assoiation of
Norteastern Pennylvana with rear to
£n reserves, actuariãi liabilties, and related items.
Wave examned the assumptions and methods used in determning loss rees, actarial
liabilties, and related items liste below as shown in the annual stateent of prepared for fiing with state regulatory offcials as of
the corption as
December 31,1992:
1) Claims unpaid (Page 3,
Item I)
$96,243,596
$ 2,496,274
2) Unpaid Claims aciustment expenses
(Page 3, Ite 3)
My examination included such review ofthe assumptions and method usd and of
the underlying
the ite identified above
basc records and summes and such tests and calculations as I consder necess.
In my opinion, the amounts carried in the balance sheet on account of
ar in accordance with accpte actuarial standards consistently applied and fairly stated in
accrdance with sound actuarial principles. are based on actuaral asptions relevant to
contract provisions and appropriate to the purpo ror which the Stateent was prpard. meet the requirements ofthe laws of the Common weal Lh or Pennsy lvania and mae go and sufcient provisions for all unpaid ciA im!l and other actuarial liabilties under the te arits contrct and
agrements, are computed on the basis of assum~tions consistet with thos used in comllutig the corrs~nding items 1n the anual statement or Decmber 31, 1991, and inelude appropnate
provision for all actuaral items which ought to be establhmed.
~~_1-/~
Sincerely,
L Harack
JB:r
B-81
NEPAOOOO296
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 20 of 55
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NEPAOO297
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
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Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 22 of 55
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NEPAOO299
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 23 of 55
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Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 26 of 55
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Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 27 of 55
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NEPAOO30
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 28 of 55
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B-90
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 29 of 55
Fa 13
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B-91
NEPA0
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 30 of 55
Defendant's Exhibit # 8
B-92
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 31 of 55
I
PENNSYLVANIA
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ANNUAL STATEMENT
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01' TH.
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Hospital 5ervice Association of Northeastern Pennsylvania
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Wi lkes-Barre
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Insurance Commissioner
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COMMONWEALTH OF PIINSYLVANIA
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1993
B-93
NEPA001B
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 32 of 55
fo". 13
HOSPITAL. ~EDICAl ;ND DENTAL SERVICE OR IHlEI1T CORPORTIONS
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l~lU~llDlllllmllmllllillll~' 'IIPU& _ici ASK. . 1.1. II -l... It
ANNUAL STATEMENT
For the Year Ended December 31. 1993
OF THE CONDITON AND AFFAIRS OF THE
HAl C Group Codo: 00
MAIC Ci-y Code: 547'7
úil
oyer , i 1D iiir: 24-015177
O..on;ud widor tho La.. of tho Shtt of PENNSYLVANIA
. II. to thi
INSURANCE DEPARTMENT OF THE STATE OF Pennsyl van; a
PURSUAN TO THE LAS THEREOF
Incorpor.ted: 11/28/1938
S ta tutory H_ Offl ce: 70 "OAH MA I" STEET
C-led ...In...:
12/01/1938
. WILKES-BARRE PA 18711
Miin Adlnhtritive Officii 70 IORTH ~IN STRErr
WI LlES.8ARE PA 1871 1
I1 II Address: 70 NORTH * ILL STR Er
r 71l1l1-lU
. WILKES-BARRE. PA 18711 ,
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WILlES-BARE PA 18711 r711111-lU
AnnuiI Stlt_nt Contlct Person ind Phl NlIrl IIllllAM JOSEPH SMLaK (117)82-5011
PI"IIII' Location of looki an Records: 70 NORTH MAIl STRErr
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OFFICERS
Priiidint . CEO: THQS JOHlll
Socretiry: KEITH JOSEPH SADERS
T...u..ri MICHAEL PATRICK GALLAGIER ,
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Pn"1I1 . ..
Coty if WZERE
Vice Presidents/Officers
OK
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DIRECTORS OR TRUSTEES
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Sta.i of Pen.y! yoni.
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iF ~ - '",_. øo. am Il-i we.. .. ..Ivl "! if u. ..14 I...r. f... ... ii.. li .. U.. er cl.t. ~ lad, .11., t" 1M... .IN"",JI _II le..". ,.."','S'.l~ -1f r..._. of frw~~!M fi. r... ..t ii IItl ItaUf." ti tIh ..., it..'. tat_ wtl- "I... 1Ù1I~tt.. .--,.. ... ..i-it.. tlt. l-... __ II ref.. ,. h i 'un IN 'ni iUl- .1 in 1MIU I... ... .HitiiN i. fol- tM JIer 1M.. tat Uh.Ui ..14.. ..1...ta ....1... It..nIU.. UM if u. ...t1_ .. at'it" .. aM .. t.. .. ., hi Ui1rl,-ftnt ..., .f Dt"'r liit. .. if
'.. 1, l-l. ,te ....u u,. i- tM, .,. tH .. "IH. c.n, .1.. I"..,.. ii .. t.. ";,... .l
acan. .tt~ .., 4tf1," il- (I) Il-t st.,. ..I.. ... ..I-lL.. ..1.. IUffH"t... ,re..". ....,. .. .. - ".tce. 1M ... ..1.. ir. _U: ..) nit_li tnalNU",' .. UAØit.. ,,.'lc,. '" ..rt.. ..I ,.t.,.. ti .... _l- ,_tI (1) atete 1_
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co tt'i IH" If ,..ir Uifl1tt..., 1m... .. .,1t.( l r..",Ch.I,.
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My CC Ei ft 24. ,-B-94
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NEPAOO519
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 33 of 55
Fol' ii A.'lL STATEMEØT FOA THE TEA 1993 OF THE HOSPITAL SERfCE ASSOC. ~f N.E. PA
mlllDllilllillilmlillilDllIl;
..nAl -icz lS. :' '.1. PI
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ACTU~ATEMENT
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JOHN HARK, A.e.A.S., :'1.A.A.A.
CONSVLT:'G ACRY
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2429 Prospeei Aveue I Evaaiion. Ilinois 6001
Phon (i08l 328-$374
.January 21, 1994
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The Honorable Cyntha M. Malesi Iiiuranc:e Commissioner Pennsylvania Iniurance Deparent
Strwberr Squar
Harsburg, Penniylvania 17120
13th Floor
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Dear Comissoner.
I, John Harack, Consulting Actuary, am a memer of the America Academy or Aces aid
have been retaned by Haspi ta Service Assation ofNortea Pennsylvania with rega to
loss reserves, actuarial liabiltiei, and related items.
I have examned the assumptions and methods usd in deleg 101S reaea acal
prepar ror filing with state regulatory ofJals as of
liabil ties, and relate items listed below ai shown in the anuaitateent otthe COrptiOD as Decber 31, 1993:
1) Claims unpaid (Page 3, Ite 1) 584,870,623
2) Unpaid Clais adjusent expenses
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(Page 3, Item 3) $2,560,814
My exaination included such review or the Ulptions and methods us aid orth. wierlying basic records and summares and such te and calculations as I cosider iu.
In my opinion, the amouiits cared in the balance sheet on accunt olthe ite identied above
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contrct provisions and appropriate to the pW" ror which the Statet was prpan meet the
accordance with sound actuarl princ:iple, ar bas On acal usptiou reevat to
the laws Or
are in accordnce with accepte actuaralsta cotetly appUed an fail)" aite in
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requireents of
the Comnwealth oIPemsylvana an mae go an nfcient
stateent orDecbe S1, 1992, and includ appate provision for all actaral ite which ought to be estbliihed.
corrsponding items in the annual
agrements, are COl)ute 011 the basi of auptOZlS costt with thos us in COuting the
provisions for all UDpad claims and other actuaalliabfUtili unde th ienn allb cmtr aD
Sincerely,
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B-95
NEPA020
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 34 of 55
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HOSPITA SERCE ASSOCIATIOI OF IfR'1'l PENSYLVlA
Anual Statemet tor the rear ~993
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T1S PMB DIODY LU BL
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B-96
NEPA0021
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 35 of 55
fO", 13 ~NUL STATtNT FOR THE TEA 1993 OF lME HOS~ITAL SEAVICE ASset. Of I.E. 'A
"AM NO ED 2
ASS ETS
t. lenulll.... ..................0.......0..... ........ ............0.. ......0... ...... ......... ........... .0....... 0......0... ..... '0'
i. Stock.:'
Gee..' 31, o..r 31.
I"' 1"2
lIS,453,03S .... 9,,6go.6Ie
................. ....,...........
2.1 ,..fo.re itllki .......... .....,.............. ........ ..,........,........, ..................
Z,Z C_' "DCk. ...................,.......... ............ .........., ........................... .., lot,76Z.656 .... 15,611,112
3, Iin9.!0.n. "" rCiI ,.Ute ..................,......,.......................................... ......,......... ................
e, Rul .n.t" loll $............. D ..euirinc., .........................................,....... ..... 3,m,lC1 ..... 4,33',401
S. col1l..'" 101", ......,......................",..............,.......................,...., ...... ................ ... ......... ....
6.1 to'" Oft hind and on d.IIU ...............................................................,...... .... (J.nS.51') .... (4,W3.55e)
'.2 Slort_t...ln.iit-i. ...............;........................................................... .... Jl.7OJ,UI .... 50,44._
1, An..... wrlte-t.i flir I...... ...... .............,............................................ .... 14.e06.316 ..... .,05,331
IA. Subutals. cuh lid llwesUt 1...U, (It_ 1 to 1) ,............................................. .., 174.71i,007 ... Z47.ui.7.
I. u..oii.n'" p..l.. ............................................................................. .... 11,779.571 .... zi,m,7n
................ .................. t. _" ...iY..l. r,I.U", to u.tnaurn iochlen. ... h..l.h ph.. ...................,........... ................ ................
10. Fu.d. held by 0. ..pOlted .Ith reinsure _I.. ..............................................
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11. RlIOIUr.1i ree"".rables ~i10.. IO. loii idjiit_ftt pi)'U ........................,...........
................ ................ ................ ................
................
.... 3& 071 ZN .., 310.349,51
12, ride..l t_ toa _.1..1, ....,..............................................................
..... 2,03,715 13. Interat ind oihr 1....t_t I.CO di. llI iecr ............................................. ..... 3,301,501 ..... 3,211,173 ie, Rleeh..l. f.. ,...t. ..b.ldt.r1.. .. ..filiate. .............................................. ..... 1,711,757
15. tllctl'le doti proliii., "Ul.... ............................................................. ................
11. Avr'lne wrte-l.1 for .the t~.. i....ud IIIIU .... ..............................,............ .... 37 .a..
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19. foull (It_ lA to II) ..................................................................... ... 336,04.12e
DETAIU DF WAITE.
INS AGR£TED AT LINE 7 FDR INVESTED ASSETS
..... 8."5,455 ..... 4,703,793
1. IM OF NOlTHEASTDl PEJSTLVNlIA ................................................................ OZ. CAPITAl 5£1Vl~£S COTIDI ...............................,....................................
..... 1.733,672 1,733,671
.....3.127,~i ..... 1,120."
0103. FE' AGDITS ASETS ..,..................................................:.........................
................. ................
0704. ............. ........ ..........,...., .....,...,........ ...... ,......... ..............,...... ..... ................. ................
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0705.
.................................................................................................
0711. S_l'0f _101", .rlU-h. for lIne 1 1_ ovrfl.... .....:.............................. ................ ................
0199. Totals (Lloii 0101 th.. 0111 phil 01t1)('''. Z, llri 7) ...................................... .... 14,4O,JU ..... 1._,331
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DETAILS OF WRITE-INS AGGEGATED AT LINE 18 FOR OTHER THAl INVESTED ASSETS
1101. All _ OTHER IWE çRI 'WS .................................................................... ..... 2.6i,50 .....I,III,pO
11. All _ Clli'W .............................................................................. ..... l,e",1I ...~. i.ZD,3Z7
1103. AIR _ RECI'RO DI PlN ..........................................................,..,......... ........ ".15 ....... isa,_
lIe. AlR- MA MEDICAL ............................................................................. .... 27,10.337 .... 23,30,011
1l. All _ COfPRMDl5IVtIlPAMlii. ...............................,.................................. ..... l,nl.313 ..... 1,470.34
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11. S_l' of ral'I" win-lol for ll.e ii f_ o.erli. ..,. ......,..........................., ..... 4.:ie.Z9 ..." 5 Øl
11. louis (LiNI 1101 thfOulb 110 plus 11,,1I'lle 2. Lln. 18) ..................................... .... J7,a.i- ....31.011.z
10Tt. Th lte.. "" thl. pive to "... wtth li~i.tt i, Cii_ 4. Th ..tel to Flnanel11 Sut-lt ... an lout"l II'" .f t1llltltInt.
. Stat_ It''U of vll...t1Df.
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BONDS: Cost Plus I Minus Amrtization
STOCKS: Market Value As Stated Per NAIC Valuation of Securities Manual
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B-97
NEPA0022
Case 1:05-cv-00503-TCW
Document 30-3
Filed 02/28/2007
Page 36 of 55
;0'" 13 AlIPL $TATtDlT fOR TME YEAR 1~3 or 11E MomTAl S£1ICE AS. Dr N, E. 'A
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Dtc-, 31. 1993.
De n.
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LIABILITIES, RESERVES & OTHER FUNDS
1. Ch1.. ....id (,.rt lA, Col_ .. LI.' 5)(11l1.'" pl'hl0. fo' "tl-f'" co .iIll_'
$.... (5,703,43')) ...............,............................................................... .... 11.170.121 .... ",651.377
i. ,",",'' for 4of... _terntty 'iiefits (hrt fl. LI.. l. CIlØ1 ZI ............................ ................ ................ 3. U.IlU chI.. .4j..t_t _". (,.rt 3, LI.. 201, CLL_ 2) ................................... ..... 2.!l.811 ..... Z..H.17'
t. Unrn" p..l_ (,.rt 1. ClI_ ei ............................................................. .... 32.111,317 .... 13.571."1
5. Ui.... I.vatllnt 1_ (hrt t. Lfll'. Col_ 4) ................ò........................... ................ ................
6. (.) Tax... 1Ic.._ .nt ,...... or _no (ei1oc1.1 r..,,¡ Iii- _.1) .................... ........ 40._ ........51.13
(b) F..."! 1",_ taUS (UCI"I'" ..f... taui) ............................................. .... 13.77.it5 ..... 5.zi,7.
(c) oUi ...... _ or -t ............................................................... ..... 3,111.101 ..... i.lI,7.
7. '..11.. 'ep.lts .... b1 ."lIe..n rejectl1 .r no II ~t ac.pt II .." or .uIrlll .... ..... 1.....33 ..... 3.I2,ZII
e. 10"' _y $............. 0 .. 1.l-.t th... I............. 0 .......................... ................ ................
................ 10. Llulllty for ._n h.i. ...., ..Inii'" ...I...t .iu h..I", pI... ............................. ................ ................ 11. Fun. MI4 .. ..","UOf ..r ''1.'."- t_ii.. ............................................. ........... .....
t. _n ..I"'h.i, or ..t.i,, for '""ii 0' _" ............................................... .... 11.3l.071 ....34.lle,1o
lla. iini ,..1_ .. ..I......C. II _ItMrii" ._1.. I............. 0 .....................
12b. ..In._ 01 "Id 101'" I............. 0 .nd'. un"i. ..po- 1.._ I............. 0
.nd o. ,..... bI oot "IN...te' 10.... l............. 0 ....l'l. f_ ...tll'lIl1
COlI.. l......... .... 0 .. ...... ..................... .,. ..... ..... ...... ..... .................
1!c. '.1. ... un"I' .11octad 101. ..uii- .... _,""h f_ _dilzo
c_l.. 5............. ° ......... .................... ..... ......... ..... ................ ......
12.. UIS fund. lli. or ro.l.. bY .....tl.. for _nt ., ... unui-."
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COI" II .. Sclil. s. ,.rt Z. cil_ 1 S............. 0 .................................. ................ ................
U. ~t.l_ for Ufiui-li-l retns.rMt (Lines iii + 1U. lZc. w) ............................. 14. An..U ..It.-i.. for oihr 1I.bl1ltl.. ..................................... .......... ......... .... ID.....n. .... 18....751
15. Tot.i 111"lItt" ................................................................................ ... 1",41,_ ." 171.311.471
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RESERES NlO SPECIAL fIOS:
16. Stat.to rutni ............ ..... .... ...............,..................., ..... ........... ....... ...... .......... ..... ..... ......
17. ,,U ....,U.,n. far ......M ."1.1 hndl ............................................... ................ ..... 4,II.U'
ll. u..il'-i fUI. .......................,......................................................... ... lA....- ... ii....l
10. hUll (Lln.i 11 plUI 1'1 ................................................................... ...33.~i.124 ." 3l0.~',5I
1.. Total ..inos Ind _lpl1 f.... ChI. 4, LIne iD) ............................................ ." lA....- ... U.....-
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mAILS Of llITE-INS AGGTEO AT L11l 14 fOR oTIE. LIABILITES
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1401. MAOR 1I01CAl ....................................................... ..'................ .. ........ ..... ........... ..... I.D.QI
uoz. .DlYLYA/IA aWE siino ........................................................................ ..... 1.40,11 .....5.173.0n
lW. G£lØI UD5£1 ØnJ5E .......................................................................... ..... I.... ..... 1,2.12'
140. CO£ISIYI/l...O ........ ............................. .......................... ......... ....... ..II ..... 1...1..
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1405. iø.ilt AD HOSPITAL 'A1l ......................... ..... ........... ...... ..... ....... ....... 40._ ....... 7U1.'"
1". _1'.f ..1.1.' wrte-'" fa" lhe II f_ iiorl"'.. ................................... ..... .....nD ...... Il Il
1m. Totl. (LI,.. 1401 ti 1405 plu. 14.)("" J. L