QUARTERLY STATEMENT · 2018. 11. 19. · 3003. XXX . .XXX. 0 3098. Summary of remaining write~ins...
43
HEALTH QUARTERLY STATEMENT RECEiVED OF THE NOV 152018 COMMISSIONER OF INSURANC INSURANCE DIVISION OF IOWA Aetna Better Health of Iowa Inc. TO THE Insurance Department OF THE STATE OF FOR THE QUARTER ENDED SEPTEMBER 30, 2018 2018
Transcript of QUARTERLY STATEMENT · 2018. 11. 19. · 3003. XXX . .XXX. 0 3098. Summary of remaining write~ins...
HEALTH
QUARTERLY STATEMENT
RECEiVED OF THE NOV 152018
COMMISSIONER OF INSURANC INSURANCE DIVISION OF IOWA
Aetna Better Health of Iowa Inc.
TO THE
Insurance Department
OF THE
STATE OF
FOR THE QUARTER ENDED SEPTEMBER 30, 2018
2018
QUARTERLY STATEMENT AS OF SEPTEMBER 30,2018
OF THE CONDITION AND AFFAIRS OF THE
Aetna Better Health of Iowa Inc. NAIC Group Code ~ ~ NAIC Company Code 15805 Employer's 10 Number 47-38506n
(Curran') (Pnor) Organized under the Laws of ________ --"Io"'wa"'-________ " State of Domldle or Port of Entry IA
Country of Domicile United States of America
Licensed as business type: Health Maintenance Organization
Is HMO Federally Qualified? Yes [ No[ Xl
Incorporated/Organized _______ --'04=/2"'4"'/2,,0'-'-1"-5 ______ ~ Commenced BusIness N/A
Statutory Home Office 4320 NW 114th Street (Street and Number)
Main AdmlnlstraUve Office
Mall Address
Urbandale. IA. US 50322 (City or Town, State, Country and Zip Code)
P.O. Box 67103 (Street and Number or P.O. Box)
Pllmary Location of Books and Records
Hartford. CT, US 06156 (City or Town, State, Country and Z1p Code)
Internet Website Address
4320 NW 114th Street (Street and Number)
151 Farmington Avenue (Street and Number)
www.aetna.com
Stetutory Stetement Contact Scott David Miller (Name)
[email protected] (E-mail Address)
OFFICERS Chief Executive Officer and President ____ -"la"u"'ri"'e"'A:!!n"'n "'B"'ru"'b"ak"'er"-___ _
Vice President and Secretary ____ -'Ro=be=rt"'M"'a"'r"k"'Ke=ss"'le=r ____ _
Kevin James Casey. Senior Investment Officer John Patrick Maroney, Vice President & Treasurer
Debra Jean Bacon
OTHER
D[RECTORS OR TRUSTEES laurfe Ann Brubaker
Urbandale, lA, US 50322 (City or Town, State, Country andZlp Code)
800-872-3862 (Area Code) (Telephone Number)
Harrisburg, PA, US 17106-7103 (City or Town, State, Country and Zip Code)
800-872-3862 (Area Code) (Telephone Number)
717-671-2474 (Area Code) (Telephone Number)
717-526-2888 (FAX Number)
Chief Financial Officer ____ D"'e=b"'r"a-"J"ea'"n"-"B~ac"'o"n'___ __ _
Frank Ferris Chronister III, Assistant Controller # TimothY James Olson, Principal Financial Omcer and Controiler fJ
Janet Ruth Grant
The officers of this reporting entity being duly sworn, each depose end say that they are the described officers of said reporting entity, and that on the reporting period stated above, all of the herein described assets were the absolute property of the said reporting entity, free and clear from any liens or dalms therecn, except as herein stated, and that this statement together with related exhibits, schedules and explanations therein contained, annexed or referred to, Is a full and true statement of all the assets and liabilities and of the condition and affairs of the said reporting entity as of the reporting period stated above, and of Its Income and deductions therefrom for the period ended, and have been completed In accordance with the NAIC Annual Statement Instructions and Accourrting Practices and Procedures manual except to the extent that: (1) state law may differ, or, (2) that state rules or regulaHons require differences In reporting not related to accounting practices and prooedures, according to the best of their Information. knowledge and belief, respectively. Furthermore, the scope of this attestation by the described officers also Includes the related corresponding electronic filing with the NAIC. when required, that is an exact copy (except for formatting differences due to electronic filing) of the enclosed statement. The electronic filing may be r~uested by various regulators in neu of or In addition to the enclosed statemenl
laurie Ann Brubaker Chief Executive Officer and President
State of ........ Arizona Ccunty of ..... Maricopa
Subscribed and sworn to before me this
C) (,ti l1l: Y ,2018
LtJt
JANEEN NEWHOUSE Notary Public.State of AtiZOnB
Maricopa county, My commission Expires February 08, 2019
o . (J.. A..r ". Robert Marl< Kessler
Vice President and Secretary
State 01... ..... Arizona County of... .. Maricopa
Subscribed and swom to before me this
ebra Jean Bacon Chief Financial Officer
State of ........ Arizona County of ..... Maricopa
Subscribed and sworn to before me this
~" .. ,~.". JAI\lEEN NEWHOUSE (!.-~-1"':~.'~=:~~.( ... tJotar~ Pubhc.Slatoe of Arizona
~j'r~",,,::.)"ln Mancopa.Co\.lIlty.
~/:;,,:,'~'-'_~!J:":'IJ r-.Jly Cornm!SSlon Expires ,.~~9:y cobruary 08 2019 '~~ ''-z -,
a. Is this an original flllng7 ................... Yes [X J No [ b. If no,
1. State the amendment number ... .. 2. Date filed .................................... . 3. Number of pages attached .......... .
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
1. Bonds.
2. Stocks:
2.1 Preferred stocks
2.2 Common stocks_
3. Mortgage loans on real estate:
3.1 First liens .
ASSETS
Assets
o
o .0
o
Current Statement Date 2
Nonadmitted Assets
.. 0
... 0
o
.......... 0
3.2 Other than first liens .. 0 f ............................... .
4. Real estate:
4.1 Properties occupied by the company (less $
encumbrances) .
4.2 Properties held for the production of income (less
...
. ..
$ encumbrances) ........................... ..
4.3 Properties held for sale (less $
encumbrances) _
5. Cash ($
($
.. ..10.100 ). cash equivalents
. 1.100.080 ) and short-term
investments ($
6. Contract loans (including $
7. Derivatives _, __
premium notes) _______ _
8. Other invested assets ..................................................... . 1
.......... 0
.. .......... 0
1.110,180
o
9. Receivables for securities .................................................... . .............................................................. 0
10. Securities lending reinvested collateral assets
11. Aggregate write-ins for invested assets ..
12. Subtotals, cash and invested assets (Unes 1 to 11) ......................................... .
13. Title plants less $
only) .
14. Investment income due and accrued ..
15. Premiums and considerations:
charged off (for Title insurers
15.1 Uncollected premiums and agents' balances in the course of collection
15.2 Deferred premiums, agents' balances and installments booked but
deferred and not yet due (including $ .................................... .
earned but unbilled premiums) ... ........................................................ t 15.3 Accrued retrospective premiums ($
contracts subject to redetermination ($
16. Reinsurance:
16.1 Amounts recoverable from reinsurers
16.2 Funds held by or deposited with reinsured companies
) and
) ...
16.3 Other amounts receivable under reinsurance contracts ....................... .
17. Amounts receivable relating to uninsured plans
18.1 Current federal and foreign income tax recoverable and interest thereon ..
18.2 Net deferred tax asset.
19. Guaranty funds receivable or on deposit ..
20. Electronic data processing equipment and software
21. Furniture and equipment. including health care delivery assets
($ )
22. Net adjustment in assets and liabilities due to foreign exchange rates
23. Receivables from parent, subsidiaries and affiliates
24. Health care ($ _ ) and other amounts receivable
25. Aggregate write-ins for other than invested assets ..
26. Total assets excluding Separate Accounts. Segregated Accounts and Protected Cell Accounts (Lines 12 to 25)
27. From Separate Accounts, Segregated Accounts and Protected Cell Accounts ..
28. Total (Lines 26 and 27)
1101.
1102.
1103.
DETAILS OF WRITE-INS
1198. Summary of remaining write-ins for Line 11 from overflow page
1199. Totals (Lines 1101 through 1103 plus 119B)(Line 11 above)
2501.
2502.
2503.
2598. Summary of remaining write-ins for Line 25 from overllow page
2599. Totals (Lines 2501 through 2503 plus 2598)(Line 25 above)
..
o 1.110.180
o 2
........... 0
o
.. 0
o .......... 0
.......................... 0
.................. 0
2
.0
o o o
......... 0
............. 0
o o o
..... 1.110.182
o 1.110.182
o o o o o o o o o o
o
o
.............. 0
o .......... 0
....... 0
o o
........................ 0
................... 0
.. 0
....... 0
o
o
.0
o o
.0
o o
. .......... 0
. ...................... 0
............. 0
o o o o o
o o
.0
o o o o
............. 0
o o
.0
o
3 Net Admitted Assets
(Cols.l -2)
o
o . " ................ 0
o
4 December 31 Prior Year Net
Admitted Assets
.0
............ 0
.0
. ......................... 0 f ............................ .
. ...................... 0
....0 I ............................... .
1.110.180 ................. 1.099,725
o o .............. 0
............... 0 0
. ............ 0 f ................................ .
..... 0 0
00
. .1.110.180 ...... 1.099.725
o 2
o
o o
....... 0
.0
o o
..0
o
..... 0
.......... 0 f ............................. .
......... 0
.. 0
... 0
.. 0
......... 1.110.182
... 0
1,110.182
........... 0
o . ............. 0
.0
o o
......... 0
.............. 0
o o
.0
o
1,099,725
1.099.725
.0
........ 0
.0
o o
.. .. ..0
o .0
o o
.--<.-"-,-~--<"----------.------------------------------
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
LIABILITIES, CAPITAL AND SURPLUS Current Period Prior Year
1 2 3 4 Covered Uncovered Total Total
1. Claims unpaid (less $ reinsurance ceded) __ .0 0 0
2. Accrued medical incentive pool and bonus amounts 0 0 0
3. Unpaid claims adjustment expenses 0 0 . .0
4. Aggregate health policy reserves, including the liability of
$ 0 for medical loss ratio rebate per the Public
Health Service Act _ ............... 0 0 .................................. 0
5. Aggregate life pollcy reserves ....... 0 0 0
6. Property/casualty unearned premium reserve '" 0 0 0
7. Aggregate health claim reserves .. 0 .0 0
B. Premiums received in advance .. 0 0 0
9. General expenses due or accrued . 0 0 0
10.1 Current federal and foreign income tax payable and interest thereon
(including $ on realized gains (losses)) _ 931 0 931 1,404
10.2 Net deferred tax liability .. 0 0 0 .......
11. Ceded reinsurance premiums payable . ... .0 .0 ........... ........... ..... 0
12. Amounts withheld or retained for the account of others .. ................... 0 ............................... 0 . ...... 0
13. Remittances and items not allocated ............................. .0 .0 0
14. Borrowed money (including $ current) and
interest thereon $ (including
$ current) .. . .............. 0 0 0
15. Amounts due to parent. subsidiaries and affiliates. ............................. .705 .................................. 0 .. .705 . ... . ............... 543
16. Derivatives .................................. 0 .................................. 0 . 0
17. Payable for securities . ....... .......0 .............................. 0 . .......................... 0
1B. Payable for securities lending . ............. ............ 0 ........................... 0 .0
19. Funds held under reinsurance treaties (with $
authorized reinsurers, $ unauthorized
reinsurers and $ certified reinsurers) ..... 0 ................ 0 ................. 0
20. Reinsurance in unauthorized and certified ($ )
companies ............... . ..... . 0 0 .0
21. Net adjustments in assets and liabilities due to foreign exchange rates .. 0 .0 0
22. liability for amounts held under uninsured plans 0 0 0
23. Aggregate write~ins for other liabilities (including $
current) 0 0 0 0
24. Total liabilities (Lines 1 to 23) 1,636 0 1,636 1,947
25. Aggregate write~ins for special surplus funds .. .... ................................ ............... XXX . ..XXX . 0 0
26. Common capital stock .......... XXX. XXX .. 10 10
27. Preferred capital stock . ...... ......... XXX . ........... ............ XXX .. 0
2B. Gross paid in and contributed surplus ............. XXX .............. ............... XXX .. . . .... .. 1,099,990 . .... ....... 1,099,990
29. Surplus notes. ...... XXX . ............ . .............. XXX ... 0
30. Aggregate write~ins for other than special surplus funds .. . ............. XXX. XXX. 0 0
31- Unassigned funds (surplus) ............................................................................. ..... .XXX. XXX B,546 (2,222)
32. Less treasury stock, at cost:
32.1 shares common (value included in Line 26
$ ) . XXX .XXX 0
32.2 shares preferred (value included in Line 27
$ ) XXX XXX. ............................... 0
33. Total capital and surplus (Lines 25 to 31 minus line 32) XXX. .XXX .. ~. . ... 1,108,546 . ................... 1,097,778
34. Total liabilities caoital and surolus (lines 24 and 3~) XXX XXX 1,110,182 1,099,725
DETAILS OF WRITE-INS
2301. 0 ... 0 ..0 0
2302. 0 0 0 0
2303. 0 0 0 0
2398. Summary of remaining write-ins for line 23 from overflow page 0 0 .0 0
2399. Totals (Lines 2301 through 2303 plus 2398)(Line 23 above) 0 0 0 0
2501. .... XXX. .. XXX .. .0 . ..................... 0
2502. .............. XXX .. . ..... .............. XXX .. 0 . ...................... 0
2503. XXX XXX 0 .. 0
259B. Summary of remaining write-ins for Line 25 from overflow page .. .. XXX .. XXX . . ............ .......... .. 0 ................. ..... 0
2599. Totals (Lines 2501 throuah 2503 olus 259BHLine 25 above) XXX XXX 0 0
3001. .. ............ XXX. ............... XXX .. 0 0
3002. XXX XXX ... 0 . ................................ 0
3003. XXX . .XXX. 0 0
3098. Summary of remaining write~ins for Line 30 from overflow page XXX ... .. . .. XXX ... 0 ..... ............... 0
3099. T01als (Lines 3001 through 3003 plus 3098)(Line 30 above) XXX XXX 0 0
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STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
STATEMENT OF REVENUE AND EXPENSES Current Vear Prior Year Prior Year Ended
To Date To Date December 31 1 2 3 4
Uncovered Total Total Total
1. Member Months _. XXX .
2. Net premium income ( including $ non-health
premium income) ... . .............. XXX .. ......... .............. 0
3. Change in unearned premium reserves and reserve for rate credits ___ XXX 0
4. Fee-for-service (net of $ medical expenses) __ XXX 0
5. Risk revenue .. . .............. XXX .. .0
6. Aggregate write-ins for other health care related revenues. . ... XXX .. . .. 0 0 . 0
7. Aggregate write-ins for other non-health revenues XXX . .. 0 0 .0
8. Total revenues (Lines 2 to 7) .XXX. 0 0 0
Hospital and Medical:
9. Hospital/medical benefits ....... 0 ..... 0
10. Other professional services 0 0
11. Outside referrals .. 0 0
12. Emergency room and out-ot-area 0 0 . .....
13. Prescription drugs . ................... 0 ............................ 0
14. Aggregate write-ins for other hospital and medical ............................... 0 . ......................... 0 ..................... ~ .......... D .................................. 0
15. Incentive pool, withhold adjustments and bonus amounts .0 0
16. Subtotal (Unes 9 to 15) ................. .. 0 ............................... 0 .................. ............0 .0
Less:
17. Net reinsurance recoveries _. ... 0 .0
18. Total hospital and medical (Unes 16 minus 17) .. ................................ 0 .................................. 0 ................................... 0 . ............................. 0
19. Non-health claims (net) . ........................ 0 ................................ 0
20. Claims adjustment expenses, including $ cost
containment expenses 0 0 0
21. General administrative expenses 0 0 8,882 8,881
22. Increase in reserves for life and accident and health contracts
(including $ increase in reserves for life only) .. .. 0 0 0
23. Total underwriting deductions (Lines 18 through 22) ... 0 0 8.882 8.881
24. Net underwriting gain or (loss) (Lines 8 minus 23) ......... XXX 0 ... ...........(8,882) . (8,881)
25. Net investment income earned ....................... 0 ....................... 13.630 2,637 . ...... ........... 5,462
26. Net realized capital gains (losses) less capital gains tax of
$ ................. 0 . ........................... 0
27. Net investment gains (losses) (Lines 25 plus 26) ........ 0 ........ ......... ..13,630 ...................... 2.637 ........................... 5,462
28. Net gain or (loss) from agents' or premium balances charged off ((amount
recovered $ )
(amount charged off $ )1 0 0
29. Aggregate write-ins for other income or expenses ................................... 0 .0 .. 0 .. 0
30. Net income or (loss) after capital gains tax and before all other federal income taxes (Unes 24 plus 27 plus 28 plus 29) .. XXX 13.630 (6,245) (3,419)
31. Federal and foreign income taxes incurred _. XXX 2,862 (2,186) (1,197)
32. Net income (loss) (Unes 30 minus 31) XXX 10,788 (4,059) (2,222)
DETAILS OF WRITE-INS
0601. XXX 0 0 ... 0
0602. .XXX .. 0 0 0
0603. ............... XXX .. ........................... ~ .... D .................................. 0 ............. ...... 0
0698. Summary of remaining write-ins for Line 6 from overflow page ............. XXX .. .-.-. 0 ......... 0 0
0699. Totals (Unes 0601 throuah 0603 olus 0698HUne 6 above) XXX 0 0 0
0701. .. -.- ........................... f XXX ......................... 0 . ..................... 0 ................................ 0
0702. XXX. 0 0 ............ 0
0703. XXX 0 0 0
0798. Summary of remaining write-ins for Line 7 from overflow page .. XXX 0 0 0
0799. Totals (Unes 0701 through 0703 plus 0798)(Une 7 above) XXX 0 0 0
1401. I 0 I 0 ......... 0 0
1402. 0 0 .0 ....... 0
1403 .0 .. 0 .0 ... 0
1498. Summary of remaining write-ins for Line 14 from overtlow page 0 0 .. 0 0
1499. Totals (Unes 1401 throuah 1403 olus 1498)(Une 14 aboveL 0 0 0 0
2901. 0 0 0 ....... 0
2902. ....... 0 0 0 0
2903 0 0 0 ........................... 0
2998. Summary of remaining write-ins for Line 29 from overflow page. 0 0 ................... 0 ................................. 0
2999. Totals (Unes 2901 through 2903 plus 2998)(Une 29 above) 0 0 0 0
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--------------------------, .,.-,,,--_. --
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
STATEMENT OF REVENUE AND EXPENSES ( Continued) 1 2 3
Current Year Prior Year Prior Year Ended to Date to Date December 31
CAPtTAL AND SURPLUS ACCOUNT
33, Capital and surplus prior reporting year ... 1.097.778 1.100.000 . ,.,1,100,000
34. Net income or (loss) from Line 32 " '"'' "JO,788 '" "" -14,059) , (2,222)
35, Change in valuation basis of aggregate policy and claim reserves 0
36- Change in net unrealized capital gains (losses) less capital gains tax of $ 0
37, Change in net unrealized foreign exchange capital gain or (loss) .. .. 0
38, Change in net deferred income tax .. 0
39, Change in nonadmitted assets .. 0 0
40 Change in unauthorized and certified reinsurance " """"",0 """"" """,,0 ,0
41- Change in treasury stock __ """"""""""""",,,,,1 "'"'''''''''''''''' ,,,0 0
42, Change in surplus notes __ .0 . 0 '" '"'''' """""",,0
43, Cumulative effect of changes in accounting principles ... "'" ,,0
44, Capital Changes:
44,1 Paid in "'" .. ".,,, .. , .. ,,,.,.0 ,,,,,.,,,,,,,.,,.,,,.,0 , .. , .... 0
44.2 Transferred from surplus (Stock Dividend) 0
44.3 Transferred to surplus. 0
45, Surplus adjustments:
45.1 Paid in """"""""""""""",,1 '"'' " ... ,,,.,,,,.,,,, ... ,, .. ,,0 ,,,,,, .. ,,,,,,,.,,,.,,,,.,,,.,,.0
45,2 Transferred to capital (Stock Dividend) .................. .0
45.3 Transferred from capital .. 0
46, Dividends to stockholders . .. " , ,0
47, Aggregate write·ins for gains or (loss8s) in surplus .. .,,, ... 0 "",,,,,,,,.,0 """"" """ '''' ,0
48, Net change in capital & surplus (Lines 34 to 47) 10,788 . (4,059) . . (2,222)
49, Capital and surplus end 01 reportina period (Line 33 plus 48) 1,108,546 1,095,941 1,097,778
DETAILS OF WRITE-INS
4701- .......... 0 0 0
4702. 0 0 ... ""."" ... ,.0
4703, .0 0 0
4798. Summary of remaining write-ins for Line 47 from overflow page .0 0 " ".",,,,,,,,,,.,,,.,,,,,,,,,0
4799- Totals (Lines 4701 throuah 4703 plus 4798)(Line 47 above) 0 0 0
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."~",.~-,>,,,,-,,,,,,,,~.-.-------.,,,---------------------------------------
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
CASH FLOW 1 2 3
Current Year Prior Year Prior Year Ended To Date To Date December 31
Cash from Operations
1. Premiums collected net of reinsurance 0 0 ................ 0
2. Net investment income 13.628 ........... 2.637 5.462
3. Miscellaneous income 0 0 0
4. Total (Lines 1 to 3) .. 13,628 2,637 5,462
5. Benefit and loss related payments ... .. 0 0 0
6. Net transfers to Separate Accounts, Segregated Accounts and Protected Cell Accounts ..
7. Commissions, expenses paid and aggregate write-ins for deductions 0 ........ 8,882 8,881
8. Dividends paid to policyholders . ..............
9. Federal and foreign income taxes paid (recovered) net of $ . tax on capital
gains (losses) .. 3,335 (3,104) (2,560)
10. Total (Lines 5 through 9) .. 3,335 5,778 6,321
11. Net cash from operations (Line 4 minus Line 10) .. 10,293 (3,141) (859)
Cash from Investments
12. Proceeds from investments sold, matured or repaid:
12.1 Bonds 0 0 ..................... 0
12.2 Stocks. ..................... 0 0 .... 0
12.3 Mortgage loans 0 0 ... ... ...... 0
12.4 Real estate ....... 0 0 .0
12.5 Other invested assets 0 ..................... 0 0
12.6 Net gains or (losses) on cash, cash equivalents and short-term investments ....................... 0 · .0 0
12.7 Miscellaneous proceeds ............. 0 0 0
12.8 Total investment proceeds (Lines 12.1 to 12.7) .0 ................ 0 .0
13. Cost of investments acquired (long-term only):
13.1 Bonds .. 0 0 . ......... 0
13.2 Stocks 0 ............. 0 0
13.3 Mortgage loans 0 · .0 0
13.4 Real estate .. ..0 0 0
13.5 Other invested assets 0 ............................ 0 .0
13.6 Miscellaneous applications _ 0 0 0
13.7 Total investments acquired (Lines 13.1 to 13.6) ... 0 0 0
14. Net increase (or decrease) in contract loans and premium notes .. 0 0 0
15. Net cash from investments (Line 12.8 minus Line 13.7 and Line 14) 0 0 0
Cash from Financing and Miscellaneous Sources
16. Cash provided (applied):
16.1 Surplus notes, capital notes ......... ... ... ......... 0 · .0 .0
16.2 Capital and paid in surplus, less treasury stock 0 ......................... 0 .0
16.3 Borrowed funds_ 0 0 0
16.4 Net deposits on deposit-type contracts and other insurance liabilities_. 0 ...................... 0 0
16.5 Dividends to stockholders .. .................. 0 .0 .................... 0
16.6 Other cash provided (applied) . 162 1.787 638
17. Net cash from financing and miscellaneous sources (Line 16.1 through Line 16.4 minus Line 16.5 plus Line 16.6) 162 1,787 638
RECONCILIATION OF CASH, CASH EQUIVALENTS AND SHORT-TERM INVESTMENTS
18. Net change in cash, cash equivalents and short-term investments (Line 11, plus Lines 15 and 17) ..10,455 (1,354) . . ..... j221)
19. Cash, cash equivalents and short-term investments:
19.1 Beginning of year ...... 1,099,725 1,099,946 . ........... 1,099,946
19.2 End of period (Line 18 plus Line 19.1) 1,110,180 1,098,592 1,099,725
Note: Su lemental disclosures of cash flow information for non-cash transactions:
6
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
Exhibit of Premiums, Enrollment and Utilization
NONE Claims Payable - Aging Analysis of Unpaid Claims
NONE Underwriting and Investment Exhibit
NONE
7,8,9
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
NOTES TO FINANCIAL STATEMENTS
1. Summary of Significant Accounting Policies and Going Concern
A. Accounting Practices
The accompanying statutory financial statements of Aetna Better Health of Iowa Inc. ("the Company"), indirectly a wholly-owned subsidiary of Aetna Inc. ("Aetna"), have been prepared in conformity with accounting practices prescribed or permitted by the Iowa Insurance Division ("Iowa Department") ("Iowa Accounting Practices") The Iowa Department recognizes only statutory accounting practices prescribed or permitted by the State of Iowa for determining and reporting the financial condition and results of operations of an insurance company, which include accounting practices and procedures adopted by the National Association of Insurance Commissioners' ("NAIC") Accounting Practices and Procedures Manual ("NAIC SAP").
A reconciliation of the Company's net income and surplus between NAIC SAP and practices prescribed and permitted by the State of Iowa for the periods ended September 30,2018 and December 31,2017 is as follows:
NET INCOME
(1) State basis (Page 4, Line 32, Columns 2 & 4)
(2) State Prescribed Practices that increaseJ(decrease) NAIC SAP:
(3) State Permitted Practices that increaseJ(decrease) NAIC SAP:
(4) NAIC SAP (1-2-3=4)
SURPLUS
(5) State basis (Page 3, Line 33, Columns 3 & 4)
(6) State Prescribed Practices that increase/(decrease) NAtC SAP:
(7) State Permitted Practices that increaseJ(decrease) NAIC SAP:
(8) NAIC SAP (5-6·7=8)
FIS SSAP# Page
xxx xxx
xxx xxx
xxx xxx
xxx xxx
B. Use of Estimates in the Preparation of the Financial Statements
FIS Line #
xxx
xxx
xxx $
xxx
2018
10,768
10,768
1,108,546 $
1,108,546
2017
(2,222)
(2,222)
1,097,778
1,097,778
The preparation of these financial statements in conformity with Iowa Accounting Practices requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and revenues and expenses. Actual results could differ from those estimates.
C. Accounting Policies
(1) through (5) - No significant change.
(6) Securities Lending
The Company engages in securities lending by lending certain securities from its investment portfolio to other institutions for short periods of time. Borrowers must post cash collateral in the amount of 102% to 105% of the fair value of a loaned security. The fair value of the loaned securities is monitored on a daily basis, with additional collateral obtained or refunded as the fair value of the loaned securities fluctuates. The collateral is retained and invested by a lending agent according to the Company's guidelines to generate additional investment income for the Company. Pursuant to Statements of Statutory Accounting Principles ("SSAP") No. 103R - Transfers and Servicing of Financial Assets and Extinguishments of Liabilities ("SSAP No. 103R"), collateral required under the Company's securities lending program is carried on the Company's Statutory Statements of Assets and Liabilities, Capital and Surplus as both a receivable and payable. Also pursuant to SSAP No.1 03R, if the collateral received from a counterparty is less than 100 percent at the reporting date, the difference between the actual collateral and 100 percent is nonadmitted. Collateral value is measured and compared to the loaned securities in aggregate by counterparty. The Company did not have any loaned securities at September 30, 2018.
10
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
(7) through (21) - No significant change.
D. Going Concern
As of November 13, 2018, management has evaluated whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the Company's ability to continue as a going concern and management has determined that it is not probable that the Company will be unable to meet its obligations as they become due within one year after the financial statements are available to be issued. Management will continuously evaluate the Company's ability to continue as a going concern and will take appropriate action and will make appropriate disclosures if there is any change in any condition or events that would raise substantial doubt about the Company's ability to continue as a going concern.
2. Accounting Changes and Corrections of Errors
The Company did not have any accounting changes or corrections of errors in the period ended September 30, 2018.
3. Business Combinations and Goodwill
No significant change.
4. Discontinued Operations
No significant change.
5. Investments
A. - C: No significant change.
D. Loan-Backed Securities
(1) Prepayment assumptions for single class and multi-class mortgage backed/asset backed securities were obtained from industry market sources.
(2) The Company had no other-than-temporary impairment ("OTTI") losses during the third quarter of 2018 on loan-backed and structured securities in which the Company had the (1) intent to sell, (2) did not have the intent and ability to retain for a period of time sufficient to recover the amortized cost basis or (3) present value of cash flows expected to be collected is less than the amortized cost basis of the securities in accordance with Statements of Statutory Accounting Principles ("SSAP") No. 43R, Loan-Backed and Structured Securities ("SSAP No. 43R").
(3) The Company had no recognized OTTI on loan-backed and structured securities currently held, in which the present value of cash flows expected to be collected is less than the amortized cost basis, at the reporting date September 30,2018.
(4) The Company had no unrealized loss position on loan-backed and structured securities held by the Company at September 30, 2018.
E. Dollar Repurchase Agreements and/or Securities Lending Transactions
(1) and (2): No significant change.
(3) Neither the Company nor its agent has accepted collateral that is permitted by contract or custom to sell or repledge as of September 30, 2018.
(4) through (7): No significant change.
F. The Company did not have any repurchase agreements transactions accounted for as secured borrowing at September 30, 2018.
G. The Company did not have any reverse repurchase agreements transactions accounted for as secured at September 30, 2018.
H. The Company did not have any repurchase agreements transactions accounted for as a sale at September 30, 2018.
I. The Company did not have any reverse repurchase agreements transactions accounted for as a sale at September 30, 2018
J. through L: No significant change.
M. The Company did not have any working capital finance investments at September 30, 2018.
N. The Company did not have any offsetting and netting of financial assets or liabilities at September 30, 2018.
10.1
----~~----~--~,--------.... - .... ------------------------------STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
O. through R: No significant change.
6_ Joint Ventures. Partnerships and Limited Liability Companies
No significant change.
7. Investment Income
No significant change_
8. Derivative Instruments
No significant change.
9. Income Taxes
No significant change.
10. Information Concerning Parent Subsidiaries, Affiliates and Other Related Parties
No significant change.
11. Debt
A. The Company did not have any items related to debt, including capital notes at September 30, 2018_
B. The Company did not have any Federal Home Loan Bank agreements at September 30, 2018.
12. Retirement Plans. Deferred Compensation Postemployment Benefits and Compensated Absences and Other Postretirement Benefit Plans
The Company did not have a retirement plan, deferred compensation plan, or other postretirement benefit plan at September 30, 2018_
13. Capital and Surplus. Shareholders' Dividend Restrictions and Quasi-Reorganizations
No significant change.
14. Liabilities, Contingencies and Assessments
No significant change.
15. Leases
No significant change.
16. Information About Financial Instruments With Off-Balance Sheet Risk and Financial Instruments With Concentrations of Credit Risk
No significant change.
17. Sale. Transfer and Servicing of Financial Assets and Extinguishments of Liabilities
A. Transfers of Receivables Reported as Sales
No significant change.
B. Transfer and Servicing of Financial Assets
(1) No significant change.
(2) and (3): The Company did not have any servicing assets or liabilities at September 30,2018.
(4) The Company did not have any securitized financial assets at September 30,2018.
(5) through (7): No significant change.
C. Wash Sales
(1) The Company did not have any wash sales for the period ended September 30,2018.
18. Gain or Loss to the Reporting Entity from Uninsured Plans and the Uninsured Portion of Partially Insured Plans
No significant change.
19. Direct Premium Written/Produced by Managing General AgentslThird Party Administrators
10.2
~~--.,.-.-----------------------------
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
No significant change.
20. Fair Value Measurements
A. and B.
The Company had no material assets or liabilities measured and reported at fair value at September 30, 2018
C. Certain of the Company's financial instruments are measured at fair value in the financial statements. The fair values of these instruments are based on valuations that include inputs that can be classified within one of three levels of a hierarchy established by U.S. generally accepted accounting principles. The following are the levels of the hierarchy and a brief description of the type of valuation information ("inputs") that qualifies a financial asset or liability for each level:
Level 1 - Unadjusted quoted prices for identical assets or liabilities in active markets.
Level 2 - Inputs other than Level 1 that are based on observable market data. These include: quoted prices for similar assets in active markets, quoted prices for identical assets in inactive markets, inputs that are observable that are not prices (such as interest rates and credit risks) and inputs that are derived from or corroborated by observable markets.
Level 3 - Developed from unobservable data, reflecting our own assumptions.
Financial assets and liabilities are classified based upon the lowest level of input that is significant to the valuation. When quoted prices in active markets for identical assets and liabilities are available, we use these quoted market prices to determine the fair value of financial assets and liabilities and classify these assets and liabilities as Level 1. In other cases where a quoted market price for identical assets and liabilities in an active market is either not available or not observable, we estimate fair value using valuation methodologies based on available and observable market information or by using a matrix pricing model. These financial assets and liabilities would then be classified as Level 2. If quoted market prices are not available, we determine fair value using broker quotes or an internal analysis of each investment's financial performance and cash flow projections. Thus, financial assets and liabilities may be classified in Level 3 even though there may be some significant inputs that may be observable.
The carrying values and estimated fair values of the Company's financial instruments at September 30, 2018 were as follows:
Not Net Asset Practicable Value (NAY)
Aggregate Admitted (Carrying Included in Type of Financial Instrument Fair Value Assets (Level 1) (Level 2) (Level 3) Value) Level 2
Bonds, Short Term. and Cash Equivalents 1,100,080 1,100,080 1,099,398 682 -.
There were no material realized and unrealized capital gains, purchases, sales, settlements, or transfers into or out of the Company's Level 3 financial assets at September 30, 2018. There were no transfers between the Company's Level 1 or 2 financial assets at September 30, 2018.
In evaluating the Company's management of interest rate and liquidity risk and currency exposures, the fair values of all assets and liabilities should be taken into consideration, not only those presented above.
D. The Company did not have any financial instruments where it was not practicable to estimate the fair value.
21. Other Items
No significant change.
22. Events Subsequent
A. Type I - Recoqnized Subsequent Events
Subsequent events have been considered through November 13, 2018 for the statutory statement issued on November 13, 2018.
The Company had no known reportable recognized subsequent events.
B. Type \I - Non-Recoqnized Subsequent Events
Subsequent events have been considered through November 13, 2018 for the statutory statement issued on November 13, 2018.
The Company had no known reportable non-recognized subsequent events.
23. Reinsurance
10.3
.-.-... _---_ .. -._--------_._------------------------STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
No significant change.
24. Retrospectively Rated Contracts and Contracts Subject to Redetermination
A. through D: No significant change.
E. Risk Sharing Provisions of the Affordable Care Act
(1) Did the reporting entity write accident and health insurance premium which is subject to theACA risk sharing provisions (YES/NO)? Yes [ ] No [ X ].
(2) through (5): Not applicable.
25. Change in Incurred Claims and Claims Adjustment Expenses
There was no material change in incurred claims and claims adjustment expense at September 30, 2018.
26. Intercompany Pooling Arrangements
No significant change.
27. Structured Settlements
No significant change.
28. Health Care Receivables
No significant change.
29. Participating Policies
No significant change.
30. Premium Deficiency Reserves
No significant change.
31. Anticipated Salvage and Subrogation
No significant change.
10.4
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
GENERAL INTERROGATORIES
PART 1 - COMMON INTERROGATORIES
GENERAL
1.1 Did the reporting entity experience any material transactions requiring the filing of Disclosure of Material Transactions with the State of Domicile, 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 the reporting entity? .......................... ...... ..... .
2.2 If yes, date of change: .
3.1 Is the reporting entity a member of an Insurance Holding Company System consisting of two or more affiliated persons, one or more of which is an insurer?
If yes, complete Schedule Y, Parts 1 and 1 A.
3.2 Have there been any substantial changes in the organizational chart since the prior quarter end?
3.3 If the response to 3.2 is yes, provide a brief description of those changes. On June 29, 2018, member interest in Medicity LLC and its subsidiaries (Novo Innovations, LLC and Allviant Corporation) was transferred to
Health Catalyst. On July 11, 2018, Canadian Insurance Company changed its name to Aetna Insurance (Hong Kong) Limited. On August 9, 2018, Aetna Partners Diversified Fund (Cayman) Ltd. was dissolved.
3.4 Is the reporting entity publicly traded or a member of a publicly traded group?
3.5 ff the response to 3.4 is yes, provide the CIK (Central Index Key) code issued by the SEC for the entity/group.
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 the entity, NAIC Company Code, and state of domicile (use two letter state abbreviation) for any entity that has ceased to exist as a result of the merger or consolidation.
3 Name of Entit State of Domicile
5. If the reporting entity is subject to a management agreement, including third-party administrator(s), managing general agent(s), attorney-
Yes I No[XI
Yes I No I
Yes [ I No I X I
Yes I X I No I
Yes I X I No I
Yes I X I No I
0001122304
Yes [ I No I X I
in-fact, or similar agreement, have there been any significant changes regarding the terms of the agreement or principals involved? Yes [ I No [ X I N/A [ If 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 ................................................................ '--__ 212~/"'3~1I~2~0.'!15'---__
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. This date 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 or the reporting entity. This is the release date or completion date of the examination report and not the date of the examination (balance sheet date) ...
6.4 By what department or departments? Iowa Insurance Division
6.5 Have all financial statement adjustments within the latest financial examination report been accounted for in a subsequent financial statement filed with Departments? .. . .......... Yes [
12/3112015
07/0612017
No [ NlA I X I
6.6 Have all of the recommendations within the latest financial examination report been complied with? .......................................................... Yes [ No [ NlA [ X I
7.1 Has this reporting entity had any Certificates of Authority, licenses or registrations (including corporate registration, if applicable) suspended or revoked by any governmental entity during the reporting period? .. Yes [ No [ X I
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 a federal regulatory services agency [i.e. the Federal Reserve Board (FRB), the OHice of the Comptroller of the Currency (OCC), the Federal Deposit Insurance Corporation (FDIC) and the Securities Exchange Commission (SEC)] and identify the affiliate's primary federal regulator.
Affiliate Name Location
11
Yes [ I No [ X I
Yes I I No [ X I
~-----~,-.--~. -. ~----------
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc,
GENERAL INTERROGATORIES 9.1 Are the senior officers (principal executive officer, principal financial officer, principal accounting officer or controller, or persons performing
similar functions) of the reporting entity subject to a code of ethics, which includes the following standards? .................................................... . (a) Honest and ethical conduct, including the ethical handling of actual or apparent conflicts of interest between personal and professional
relationships; (b) Full, fair, accurate, timely and understandable disclosure in the periodic reports required to be filed by the reporting entity; (c) Compliance with applicable governmental laws, rules and regulations; (d) The prompt internal reporting of violations to an appropriate person or persons identified in the code; and (e) Accountability for adherence to the code.
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
10.1 Does the reporting entity report any amounts due from parent, subsidiaries or affiliates on Page 2 of this statement? __ 10.2 If yes, indicate any amounts receivable from parent included in the Page 2 amount:
INVESTMENT
11.1 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:
12. Amount of real estate and mortgages held in other invested assets in Schedule SA: .. 13. Amount of real estate and mortgages held in short·term investments:
14.1 Does the reporting entity have any investments in parent, subsidiaries and affiliates? 14.2 If yes, please complete the following:
14,21 Bonds 14,22 Preferred Stock. 14,23 Common Stock ..
Prior Year-End Book/Adjusted Carrying Value
$0 .$0
$ . . .. 0 14,24 Short·Term Investments... $ 0 14,25 Mortgage Loans on Real Estate ......................................................................................................................................... $ 0 14,26 All Other ... $ .................................... 0 14.27 Total Investment in Parent. Subsidiaries and Affiliates (Subtotal Lines 14.21 to 14.26) ................................................... $ 0 14.28 Total Investment in Parent included in Lines 14.21 to 14.26 above _ $ __
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
Ves I X I No I
Ves [ I No I X I
Ves I I No [ X I
Ves I I No [ X I
Ves I I No I X [
o ................................... 0 Ves I No I X I
$ $ $ $ $ $. $ $
2 Current Quarter Book/Adjusted Carrying Value
.0
Ves [ Ves [
No I X I No I I
STATEMENT AS OF SEPTEMBER 30,2018 OF THE Aetna Better Health of Iowa Inc.
GENERAL INTERROGATORIES 16. For the reporting entity's security lending program, state the amount of the following as of the current statement date:
16.1 Total fair value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2. _
16.2 Total book adjusted/carrying value of reinvested collateral assets reported on Schedule DL, Parts 1 and 2 _
16.3 Total payable for securities lending reported on the liability page.
$ $
... $
o ... 0
o
17. Excluding items in Schedule E - Part 3 - Special Deposits, real 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 a qualified bank or trust company in accordance with Section 1, 111- General EXamination Considerations, F. Outsourcing of Critical Functions, Custodial or Safekeeping Agreements of the NAIC Financial Condition Examiners Handbook? .. Yes [ X] No [
17.1 For all agreements that comply with the requirements of the NAIC Financial Condition Examiners Handbook, complete the following:
1 2 Name of Custodian(s) Custodian Address
State Street Bank and Trust Company. State Street Financial Center; One Lincoln Street; Boston. MA 02111-900
17.2 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:
1 2 3 Name(s) Location(s) Com!>lete Exptanation(s)
All agreements corrply.
17.3 Have there been any changes, including name changes, in the custodian(s) identified in 17.1 during the current quarter? 17.4 If yes, give full information relating thereto:
Ves [ I No [ X I
1 Old Custodian
2 New Custodian
4 Reason
17.5 Investment management - Identify all investment advisors, investment managers, broker/dealers, including individuals that have the authority to make investment decisions on behalf of the reporting entity. For assets that are managed internally by employees of the reporting entity, note as such. [" ... that have access to the investment accounts"; " ... handle securities"]
1 2 Name of Firm or Individual Affiliation
Kevin J. Casey as Sr. Investment Officer A.
17.5097 For those firms/individuals listed in the table for Question 17.5, do any firms/individuals unaffiliated with the reporting entity (Le. designated with a "U") manage more than 1 0% of the reporting entity's assets? ..
17.5098 For firms/individuals unaffiliated with the reporting entity (i.e. designated with a "U") listed in the table for Question 17.5, does the total assets under management aggregate to more than 50% of the reporting entity's assets? ..
17.6 For those firms or individuals listed in the table for 17.5 with an affiliation code of "A" (affiliated) or "u" (unaffiliated). provide the information for the tabte below.
1 2 3 4
Central Registration Depository Number Name of Firm or Individual Leoal Entitv Identifier (LEI) ReQistered With
NlA Kevin J. Casey NlA Not registered.
18.1 Have all the filing requirements of the Purposes and Procedures Manual of the NAIC Investment Analysis Office been followed? 18.2 If no, list exceptions:
19. By self-designating 5*GI securities, the reporting entity is certifying the following elements for each self-designated 5*GI security: a. Documentation necessary to permit a full credit analysis of the security does not exist. b. Issuer or obligor is current on all contracted interest and principal payments. c. The insurer has an actual expectation of ultimate payment of all contracted interest and principal.
Has the reporting entity self-designated 5*GI securities? .
11.2
Ves [ I No [ X I
Ves I No [ X I
5 Investment
Management Agreement (IMA) Filed
NO ...
Ves [ X I No [
Ves [ I No [ X I
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
GENERAL INTERROGATORIES PART 2 - HEALTH
1. Operating Percentages:
1.1 A&H loss percent %
1.2 A&H cost containment percent ........................................................ %
1.3 A&H expense percent excluding cost containment expenses _
2.1 Do you act as a custodian for health savings accounts?
2.2 If yes, please provide the amount of custodial funds held as of the reporting date ................................. $ ...
2.3 Do you act as an administrator for health savings accounts? __
2.4 If yes, please provide the balance of the funds administered as of the reporting date ............................. $
3. Is the reporting entity licensed or chartered, registered, qualified, eligible or writing business in at least two states?... ..... ................. .
3.1 If no, does the reporting entity assume reinsurance business that covers risks residing in at least one state other than the state of domicile of the reporting entity?
12
Ves I I No I X I
Ves I I No I X I
Ves I I No I X I
Ves I I No I X I
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE S - CEDED REINSURANCE All New R"in.,"~n"" Treaties· Current Year to Date
2 3 4 5 6 7 8 9 Effective
Certified Date of NAic Type of Reinsurer Certified
Company NU~ber Effective r Re~~:ce I (1 t~~~n9gh 6) Reinsurer
Code Date Name of I. ·,niotinn Tvoe of Reinsurer Rating
1·············-1-························· .......... 1
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+ ................ . I·········· I······ .................. .
f··············· 1-···············-1
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1-············-1-············· -1···············
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1-···············-11-·········· ··-1-···················-1-··························· ....... . ... ... .......... ...... ....................... , ............. ·-1
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE T PREMIUMS AND OTHER CONSIDERATIONS
States, etc. 1. Alabama ....... .... ...... AL 2. Alaska. AK 3. Arizona .. 4. Arkansas __
5. California .. 6. Colorado . 7. Connecticut .. 8. Delaware ..
AZ AR CA
........ CO
CT DE
9. District of Columbia DC 10. Florida .. 11. Georgia __
FL GA
12. Hawaii ....................... HI 13. Idaho. 10 14. Illinois .. 15. Indiana
IL IN
16. Iowa IA 17. Kansas KS 18. Kentucky ................ KY 19. Louisiana .. LA 20. Maine. ME 21. Maryland MO 22. Massachusetts MA 23. Michigan MI 24. Minnesota MN 25. Mississippi MS 26. Missouri MO 27. Montana ................... MT 28. Nebraska ................. NE 29. Nevada. NV 30. New Hampshire .. NH 31. New Jersey .. NJ 32. New Mexico ........... NM 33. New York ............. NY 34. North Carolina NC 35. North Oakota ........... NO 36. Ohio. OH 37. Oklahoma OK 38. Oregon ... ........ OR 39. Pennsylvania PA 40. Rhode Island .. . RI 41. South Carolina .. SC 42. South Dakota so 43. Tennessee.. TN 44. Texas __ 45. Utah ..
.. TX
UT 46. Vermont VT 47. Virginia VA
48. Washington ............. WA 49. West Virginia.. WV 50. Wisconsin ............... WI
51. Wyoming WY 52. American Samoa .... AS
53. Guam.. GU 54. Puerto Rico. PR 55. U.S. Virgin Islands .. VI 56. Northern Mariana
Islands. MP 57. Canada .................... CAN 58. Aggregate Other
Active Status
(a)
N. .. .... N ...
N. .... N.
N. .......... N. ...
N.
Current Year to Date - Allocated by States and Territories
2
Accident and Health
Premiums
3
Medicare Tille XVIII
4
Medicaid Title XIX
Direct Business Only 5 6
Federal Employees
Health Benefits Program
Premiums
Life and Annuity
Premiums & Other
Considerations
7
Property/ Casualty
Premiums
.. I· .......... ......................... ............. . .... t·····················
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8 9
Total Columns 2 Deposit-Type Thro'!9..h 7 Contracts
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..0 ..................... 0
o t .................. . o t .................. . o t ........... . o t .................. . o t ............. .
.............. 0 o t .................. . o
.. 0 .................... 0
o ..................... 0 . ................... 0
o . .................... 0 . ............... 0
o
o .0 I ................. .
Aliens .................... OT ... xxx XXX
................... 0 .................. 0 ................. 0 .... 0 .................. 0 ................. 0 .........0 59. Subtotal .. 60. Reporting Entity
Contributions for Employee Benefit Plans ..................... +
61. Totals (Direct Business) DETAILS OF WRITE·INS
XXX
XXX
o
o
.0 .. 0 .. 0 .0 ............... 0 .................... 0 ..................... 0
o o 58001. 58002.
XXX XXX
58003. ................... ......................... +... XXX t···················
58998. Summary of remaining write-ins for Line 58 from overllow page ....... XXX.. .0 .0 0
58999. Totals (Lines 58001 through 58003 plus 58998)(Line 58 above)· XXX 0 0 0
(aJ Active Status Counts: L - Licensed or Chartered - Licensed Insurance carrier or domiciled RRG ......................................... 1 E . Eligible· Reporting entities eligible or approved to write surplus lines in the state .................... 0 N - None at the above - Not allowed to write business in the state... . . .56
14
o o o .0 . .0
o o o o
R· Registered· Non-domiciled RRGs ...................... 0 Q - Qualified - Qualified or accredited reinsurer ........ 0
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y • INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 • ORGANIZATIONAL CHART
I I I I 100% 1000/0 100% 100% Ae1n_ Aetna Aetna Life Aetna Health
Health Holdings, Financial Holdings, Insurance Company and LLC LLC life Insurance
Company
06-6033492 06-0816836 (DE) (DE) (1) (eT) 60054 (1) (eT) 78700
I I I I 100% 100'Y.
Acti~~u'::atth 100%
Healthagen LLC Phoenix Data ASIWings, Solutions LLC Management. Inc. LLC
(CT) (DE) (DE) (DE)
I
I I 100% 100%
Health Data & Aetna Integrated Management Informatics, Inc.
Solutions, Inc.
(DE) (PA)
I 100,...
Futrill Limited
(NZl)
(1) InsurerslHMO's Percentages are rounded to the nearest whote percent and based on ownership of voting rights. Doub. borders Indicate entity has subsidNiries shown on the same page. Bold borders indicate entity has subsidiaries shown on a separate page •
., PHPSNE Parent Corporation is also 45% owned by third parties.
100% Aetna Inc.
(1)(PA)
100"-Aetna Health Insurance
Company of NawYork
57..0805126 (1 )(NY) 8445.
A',;~~ Holdings, Inc.
(CT)
55% PHPSNE Parent
Corporation·
(DE)
100% Aetna
International
Inc.
(eT)
I I 100% 100%
Aetna Heahh Health Re, Inc. Insurance Company
23-2710210 21-2192415 (1) (PAl 72052 (1) (VT) 13980
COnti~~~;1 Life Insurance Company of Brentwood, Tennessee
62-1181209 (1) (TN) 68500
100% American Continental Insurance Company
20-2901054 (1) (TN) 12321
I I 100% 1000/.
Echo Merger "1n_ Sub, Inc. Corporate
Services LtC
(DE) (DE)
10u% Aetna Insurance
(Singapore) Ple. Ltd.
(1)tSGP)
'''''', Aetna Global Benefits
(Bahamas) Limited
(BHS)
'0% PT. Aetna Global
Benefit Indonesia *' (ION)
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y -INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 - ORGANIZATIONAL CHART
100% Ael ..
International Inc.
ICn
I 100"
Aetna Glo'::i Benefits 10,"~ 50%
Aetna G~= Benefits Aetna ~::nghai) A.ma Health Aetna Life & Casualty Tianjin An Hai lai Insurance Company (Bermuda) Umited (Bermuda) Ltd. Hue Medical (Singapore) PTE. LTD. Enterprise Services
of Europe DAe Infonnation Co. Ltd. Technology Co. Ltd
(1) (IRL) (BMU) (1)(BMU) '5 (SGP) tCHN) (CHN)
I I I 49"'~
Aetna GI~U~ Benefits '00% SP~~:k.r
Indian Hea;;='~;anisatiOn Aetna (Beij~~;; ~nterprise Aetna Global Benefits Goodhealth Wortdwide Privatw linited *3 Managmant Services (Middle East) LLC *2 (Europe) Limited (Asia) limited Topco Limited Co., Ltd.
(INO) (CHN) (AREI (GBR) (HKG) (BMU)
I I I 100% 100" 100% 100% .. " ,..".
Goodhealth Worldwide Aetna Global Benefits Aetna Global Spinnaker Health Care Aetna Health Insurance (Global) United (Asia Pacific) limited Benefits limited Bidco limited Management Co. Ltd. (Thailand) Public
Company limited *8
(BMU) (HKG) (ARE) (GBR) (THA) (THA)
0.02% Aetna ";.:ldco Aetna "':::"Insurance Aetna ';~';.nces Indian Health
Organization Private (UK) Limited (Thailand) Public (Thailand) Limited Umited*3 Company limited *8 '11
(INO) (GBR) (THAI ITHAI
Ae~:~~Obal 100% Aetna Insurance
Benefits (UK) Company limited Limited
(GBR) (1) (GBR)
*1 PT. Aetna Global Benefits Indonesia is also 20% owned by Suhatsyah Rivai, Aetna's Nominee. *2 Aetna Global Benef"Its(Middle East) LLC is also 51% is owned by Euro Gulf LLC, Aetna's Nominee, *3 Indian Health Organisation Private Limited is 0.01985n'~ owned by Aetna Global Benefits (Asia PacifiC) and 99.980143% owned by Aetna Global Benefits (Singapore) PTE. LTD, "4 PT Asuransi Aetna Asia is also 23% owned by PT Asuransi Central Asia. "S Tianjin An Hai Tai Hua Medical Information Technology Co., Ltd is also 50% owned by Tianjin Hai Tai Group Co., Ltd *6 VirbJal Horne Health Care LL.C. is also 51,.. owned by CBO Commercial Brokers LLC "1 Health Care Management Co. Ltd. Is also owned by Aetna Global Benefits (Bermuda) limited (1 share). *8 Aetna Health Insurance (Thailand) Public Company limited is also owned by Aetna Global Benelits (Bennuda) Limited (1 share), Mr. Sansanapongpherchar (1 Share),
Mr. Jitphasong Itsaraphakded (1 Shanl); Mrs. Suphee Wattana 11 Share); and Mr. Buncha Tamphragom (1 Share) *9 Aetna Holdings (Thailand) Limited is aslo 51% owned by Mr. Paiboon Sutantivorakoon plus Aetna Benefits (Bermuda) Limited owns 1 share. *10 Minor Healltl Entreprise Co, ltd is is also (1 share) owned by Aetna Global eenef"rts lBennuda) Limited *11 Aetna Services (Thailand) Limited is also (1 share) owned by Aetna Global Benefits (Bermuda) Limited.
A~~lobal Holdings Limited
(GBR)
~:;: Korea Ltd.
(KOR)
I '9%
Aetna Holdings (Thailand) limited .,
(THAI
Hea:;'~nI Management Co.
Ltd. *1
(THAI
7, .. PT Asuransi
Aetna Asia ~4
(ION)
Aetna 'I~:~ranc. Virw:;~. (Hong Kong) Health Care LL.C.
Limited ., (HKG) (ARE)
,,% Minor Health EnbirpriH Co,
n Ltd. *1
(THA)
Min:"~~1th En",prise Co,
Ltd. *10
(THAI
~etna He::-Insuranc! (Thailand) Public
Company Limited ., ITHAI
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y - INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 - ORGANIZATIONAL CHART
100% Aetna Health Holdings, LLC
(DE)
I I I I I I I I 100,.. 100% 100% 100% 100,.. 100% 100% 100%
Aetna Health Aetna Health Aetna Health Aetna Heahh Aetna Health Aetna Health Aetna Health Aetna Network ofCalifomia Inc. Inc. Inc. Inc. Inc. Inc. Services LLC
Inc.
81-4345344 95-3402799 23..2442048 59-2411584 58.1649568 01-0504252 23-286156S 52-1270921 (CT)
(1)CA (1) (eT) 95935 (1) (FL) 95088 (1) (GAl 95094 (1) (ME) 95517 (1) (MI) 95756 (1) (NJ) 95287
I I I I I I I I 100,..
Ae~::alth 100% 100% 100% 100% 1O~" 100% 100%
Aetna Better Aetna Health Aetna Dental Aetna. Dental Aetna Dental Aetna Better Aetna Florida Aetna Better Health Inc. Inc, Inc. of California Inc, Inc, Health Inc. Inc. Health of
Inc. California Inc.
45-2634734 22-2683823 76-0189680 06-1160812 22-2990909 06-1177531 26-2867560 80.0671103 47-5178095 (1) (NY) 14408 (1) (NY) 95234 (1) (TX) 95490 (I)(CA) (1)(NJ) 11183 (1) (TX) 95910 (1) (CT) 13174 (FL) (I)(CA)
I I I I I I I I I I I 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100'Y.
Aetna Better Aetna Ekatter Aetna Better Aetna Better Aetna Better Aetna Better Aetna Better Aetna Better Aetna Better Aetna Better Aetna Better Health Inc. Health Inc. Hoa"" of Health, Ine. Heahh Inc. Health Inc. Heahh Inc. Heahh of Texas Heahh of Health of Health of
Iowa Inc. Inc. Oklahoma Inc. Washington, Inc. North Carolina Inc.
20-2207!534 27-2!512072 47-3850677 80-0629718 46-3203088 45-2764938 27-0563973 74-1644335 81-1143850 81-5030233 82-3333789 11) (GA) 12328 (1) (IL) 14043 (1) (IA) 15805 (1) (LA) 15616 (1)(NJI15611 (1) (OHI 14229 (1) (PAl 13735 (1) (TX) 95040 (1) (OK) 15919 (1){WA) 16242 (I)(NC)
I I I I I I I I I I I 100% 100,... 100% 100% 100% 100% 100% 100% I •• '. 100% 100%
Schaller Anderson Cofinity,lnc. Aetna Specialty Aetna Health Ae1na RJ( Aetna Ireland Inc. @ Credentials Inc. iTriage, LLC Delaware Ae'na Aetna Student Medical Pharmacy, Management, Home Delivery, Physicians Medicaid Health Agency
Administrators, LLC LLC LLC ea __ . Administrators Inc. Incorporated Incorporated LLC
73-1702463 (DE) (DE) (DE) (DE) (DE) (DE) (DE) (DE) (I)(OE) (Al) (MA)
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y - INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 - ORGANIZATIONAL CHART
100,.. Aetna Health Holdings,
LtC
(DE)
I 1 1 1 1 I I I 100'1'. 100% 100% 100% 1000/. 100% 100% 100% 100%
Aetna Risk Coventry Coventry Coventry Consumer Coventry Health Coventry Health Coventry Health Aetna Health Coventry Health
Assurance HaalthCare Transplant Advantage, Inc. Care National Care National Care of Ilinois, Inc. of Iowa Inc. Care Workers
Company of Management Network, Inc. Network, Inc:. Accounts, Inc. Compensation, Inc.
Connecticut Corporation 20..,376354
47-2049117 62-1411933 01"()646056 26-1293772 20-5185442 20-8070994 31-1241037 42-1244752 (DE)
(CT) (DE) (DE) (DE) (DE) (DE) (1)(IL) 74160 (1) (IA) 95241
I (
100% 100% First Script Network FOCUS Healthcare
I I I I I I 1 I SeMce, Inc. Management. Inc.
100% 100% 100% 100% 100% 100% 100% 100% 20 .... 096903 82-1266888
Coventry Health Care Aema Better Aetna Health Inc. Aetna Batter Health Aetna Batter Health Coventry Health Care Coventry Health Care Coventry Health (NV) (TN)
of Kansas, Inc. Health of of Michigan Inc. of Missouri LLC of Missouri,lnc. of Nebraska, Inc. and Life Insurance
Kansas Inc. Company
100% 100%*
4U840330 81-3370401 74-2381406 20-1052897 43-1707094 43_1372307 42-1308659 75-1296086 MetraComp, Inc. Medical
(1) IKS) 95489 111 (KS) 16072 (1) (LA195173 111 (MI) 12193 (1) (MO) 95318 (11 (MO) 96377 (1) (NE) 95925 (1) (MOl 81973 Examinations of New York, P .C.
I 06-1095987 74-2:879984
(CT) (NY)
I 1 1 I I I I -I 100% Aetna Better
Health of Kentuc ky
100% 100% 100% 100% 100% 100% 1000/. 100% Insurance Company 100%
Coventry Aetna Better HealthAssurance ..... Aetna Batter Aetna Health of Coventry Health Care Coventry Health Care Coventry
Prescription Health of Pennsyfvania, Inc. HealthAssurance Health Inc. Utah Inc. of Virginia, Inc. of West Virginia, Inc. Rehabilitation
Management Nevada Inc. Pennsylvania Inc. 47-3279217 Services, fnc.
Services, Inc. (1) (KY) 15761 87~443226
47~854096 81-3564875 23-2366731 47-4352768 20-4416606 87~345631 54-1576305 55~712129 (1)1DE)
(NV) (NV) (1)(PA) 11102 (1)1PA) 15827 (TN) (1) (UI) 95407 (11 (VAl 96555 (1) (WV) 95489
*100% owned through Aetna's nominees
100,. .. MHNet Specialty
Servic •• ,lLC
26-1582982 (MOl
~ 100% 100%
Mental Health MHNet Life and Network of New Health Insurance
Vori!: IPA, Inc. Company
37.1448790 20..2516317 (NYI (1) ITX) 12509
I I 100"1. 100%
Mental Health MHNet of Associates, Inc. Florida, Inc.
72-1106596 20-4276336 (LA) (Fl)
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y -INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
I 100-; ..
Group Dental Service, Inc.
52-1801446 (MD)
I 100%
Group Dental Service of
Maryland, Inc.
52-2056201 (1) (MOl 95846
I 100"-
Niagra Re, Inc.
(NY)
PART 1 - ORGANIZATIONAL CHART
100% Aetna HeaHh
Holdings, LlC
(DE)
100% Prodigy Health
Group,lnc.
(DE)
100"-Performax, Inc.
(DEI
100% Coventry Health
Care of Florida, Inc.
65-0986441 (1) (FL) 95114
I 100"10
Scrip Wortd, LLC
(UTI
I 100%
Florida Health Plan Administrators, LLC
20·1130063 (FL)
I '00%
carefree Insurance Services, Inc.
59-3750548 (FL)
I 100%
Precision Benefit Services, Inc,
(DE)
I 100%
Administrative Enterprises, Inc.
(AZ)
I 100%
bswffl: LLC
36-4391310 (DE)
100% 100,.. Coventry Health First Health Life &
Plan of Florida, Inc. Health Insurance Company
65-0453436 38-2242132 (1) (FL) 95266 (1) (lX) 90328
I I 100% 100%
Meritain Heatth, American Health Inc. Holding, Inc.
(NYI (OHI
I 100% '00% 100"10
U.S. Healthcare Prima Net, Inc. Professional Risk Hotdings, LLC Management, Inc.
(OHI (OHI (OHI
I 100%
First Health Group Corp.
20-1736437 (DE)
100,. .. Claims
Administration Corp.
52_1320522 (MDI
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y - INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 - ORGANIZATIONAL CHART
100% Aetna HeaHh
Holdings, LLC
(DE)
I
J I 100"1. 39.5% 0.2%
Aetna Health Aetna ACO Aeb'laACO Inc. Holdings, Inc ,. Holdings, Inc *1
23-2169745 (1) (PAl 95109 (DE) (DE)
I 0.% 0.% 510/.
Texas Health + Innovation Health BInner Health Aetna Heahh Holdings, LLC "2 and Aetna
Insurance Health Insurance Holding Company Holding Company
LLC"3 45..$521797
(TX) (DE)
I I 100% 100%
Texas Health + Innovation Aetna Health Health Insurance
Insurance Company Company
81-4749336 48-0874828 (1) (TX) 16121 (1)(VA) 15097
I I 100% 100".
Texas Health + Innovation Health Aetna Heatth Plan, Inc.
Plan Inc.
47-S548221 46-0682197 (1) (TX) 16132 (1) (VAl 15098
"1 Aetna ACO Holdings Inc. is owned by Aetna Lif.lnsurance Company (302 shares); Aetna Health Inc. (PAl (198 shares); and Aetna Health Holdings, LlC (1 share). "2 Innovation Heatth Holdings, LlC is also 50% owned by Inova Health System Foundation.
"3 Texas Heatth + Aetna Heatth Insurance Holding Company LLC is also 50% owned by Texas Health Resources. "4 Banner Heatth and Aetna Health Insurance Holding Company LLC is also 49% owned by Banner Heatth. "5 Allina Health and Aetna "surance Holding Company LLC Is also 50% owned by Al"na Heatth. "'6 Sutter Heatth and Aetna Insurance Holding Company LLC is also 50,.. owned by Sutler Heatth Plan Products Organization, LLC.
LLC"4 81.05212760
(DE)
I 100%
Banner Health and Aetna
Health Insurance Company
81-5281115 (1) (AZ) 16058
I 100%
Banner Health and Aetna
Health Plan Inc.
81-5290023 (1) (AZ) 16059
I 100'"1.
Admineo, Inc.
(AZ)
0.% Allina Health
Aetna Insurance Holding Company
LLC*S
81-5112888 (DE)
I 100%
Allina Health and Aetna Insurance Company
82-2091197 (1) (MNI 16194
I 100%
Aetna Pharmacy Manage.,..nt Services LLC
(DE)
0.% Sutter Health
and Aetna HeaHh Insurance
Holding Company LLC'"S
82-2171057 (DE)
I I 100% 100%
Sutter Health Sutler HeaHh and Aetna and Aetna
Administrative Insurance Services LLC Company
82-2560624 81-5290023 (DE) (1) (eA)
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y -INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 • ORGANIZATIONAL CHART
100% Aetna Financial Holdings, LLC
(DE)
I I I I I I 100% 100% 100% 100% 100% 100% Aetna U. S. Healthcare Aetna Workers' Managed Care Aetna Behavioral Aetna Capital
Asset Advisors, Properties, Inc. Comp Access, LLC Coordinators, Inc. Health,LLC Management, LLC LLC
(DE) (PA) (DE) (DE) (DE) (DE)
I I I 100% 100% 100% 100%*
Horizon Behavioral Aetna Card PayFlex Aetna Partners Services, LLC Solutions, LLC Holdings, Inc. Diversified Fund,
LLC
(DE) (CT) (DE) (DE)
I I I I 100% 100% 100% 100% 100% 100%
Health and Human Employee Resources Work and Family The Vasquez PayFlex Resource Center, Assistance for Living. LLC Benefits, Inc. Group Inc. Systems USA. Inc.
Inc. Services, LLC
33-0052273 (1)(CA) (KY) (TX) (NJ) (IL) (NE)
• Aetna Life Insurance Company. Aetna Health and Life Insurance Company and Aetna Health Management, LLC own substantially all of the non-managing member interests of Aetna Partners Diversified Fund, LLC.
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y • INFORMATION CONCERNING ACTIVITIES OF INSURANCE MEMBERS OF A HOLDING COMPANY GROUP
PART 1 • ORGANIZATIONAL CHART
100% Aetna Life
Insurance Company
06-6033492 (1) (CT) 60054
I I I I 100% 100% 100"0 100% 60.3%
Broadspire National AHP Holdings, Inc. Aetna Ventures, PE Holdings, LlC Aetna ACO Services, Inc. LLe Holdings, Inc. "1
(FL) (eT) (DE) (eT) (DE)
I I I I 100"/D 100% 100"D 5 ... ....
Aetna Insurance Aetna life A£ Fourteen, Texas Health + Innovation Health Company Assignment Incorporated Aetna HeaHh Holdings, LLC *2
of Connecticut Company Insurance Holding Company
LLC"3 06·1286276
(1) (eT) 36153 (eT) (eT) (TX) (DE)
I 100% 100,..
Texas Health + Innovation Health Aetna Health Insurance Company
Insurance Company
81-4749336 46..0674828 (1) (TX) 16121 (1)(VA) 15097
I 100% 100,..
Texas Health + Innovation Health Aetna Health Plan, Inc.
Plan Inc.
47-5548221 46..0682197 (1) (TX) 16132 (1)(VA) 15098
'" Aetna ACO Holdings Inc. is owned by Aeb'la Life Insurance Company (302 shares); Aetna Health Inc. (PA) (198 shares); and Aetna Health Holdings, LLC (' share). "2 Innovation Health Holdings, LLC is also 50% owned by Inova Health System Foundation. "3 Texas Health + Aetna Health Insurance Holding Company LLC is also 50"0 owned by Texas Health Resources. "4 Banner Health and Aetna Health Insurance Holding Company LLC is also 49% owned by Banner Health. "5 Allina Health and Aetna Insurance Holding Company LLC is also 500/. owned by Allina Health. "6 Sutter Health and Aetna Insurance Holding Company LLC is also 50% owned by Sutter Health Plan Products Organization, LLC.
I I 100"- 100%
Aema ResCH.Irces .. tn. L.LC. Mutti-Strategy
1099 Fund, lLC
(DE) (DE)
I I ., .. 5 ... Banner Health Alina Hearth
and Aetna Aetna Insurance Health Insurance Holding Company Holding Company LLC"S
LLC"4 81-S212760 81-5112888
(DE) (DE)
I I 100"- 100%
Banner Health Alina Health and Mb'la and Aetna
Health Insurance Insurance Company Company
81-5281115 82-2091197 (1) (Al) 16058 111 (MN) 16194
I 100%
Banner Health and Aetna
Health Plan Inc.
81-5290023 (1) (Al) 16059
I 100'Y.
canal Place, LLC
(DE)
I .... Sutter Health
and Aetna Health Insurance Holding Company
LLC"& 82-2171057
(DE)
I I 100,.. 100"-.
Sutter Health Sutler Health and Aetna and Aetna
Administrative Insurance Services LLC Company
82-2560624 81-5290023 (DE) (1)1eA)
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y PART1A DETAIL OF INSURANCE HOLDING COMPANY SYSTEM
2 3 4 5 6
NAIC Group Company 10 Federal Code Group Name Code Number RSSD CIK . 0001 .... AETNA If!:. 00000 ... 23-2229683 ... 3060706 . 0001122304. N 0001 AETNA If!: .. . ..... 00000 . 3(H)123754. 0 . 0
. 0001 AETNA If!:. ...... 00000 ..... 95-3402799. 0 .. 0 .. 0001. AETNA If!:. . ... 95935 .... 23-2442048 ... 0 ..... .......... O.
. 0001 AETNA If!:. . ..... 95088 ... 59-2411584. 0 ............... 0 . 0001 AETNA If!:. ... ... 95094 ..... 58-1649568. 0 ............... 0 ............... .
0001. AETNA If!:. .95517 ..... 01~. 0 ..... O. 0001. AETNA If!:. · 95756 ..... 23-2861565. 0 ............... 0 .. .
.. 0001 AETNA If!: ...................................... . 95287 ..... 52-1270921 ... 0 ............... 0 .. . 0001 AETNA If!:. . .... 95234 ... 22-2663623 ... 0 .. 0 .. .. 0001 AETNA If!:. ...... .14408 ..... 45-2634734 ... 0 ............... 0 . 0001. AETNA If!:. · 95490 76-<)1896S0. 0 0 .
.. 0001 AETNA If!:. ................................ .. . ..... 95040 ..... 74-1844335 ... 0 . 0 ............... . . 0001 .... AETNA If!:. ......... ..................... . · .12328 .... 20-2207534 . . 0 ............... O.
.. 0001 AETNA If!:. . ..... 00000 ..... 06-1160812 ... 0 0 .. . 0001. AETNA If!:. . .... .11183 ..... 22-299000) ... 0 ............... 0 .. . 0001 . AETNA If!:. . ... 95910 ... 06-1177531. 0 .. 0 .. . 0001. AETNA If!:. · 00000 .... 3IHl123711O ... 0 ..... .......... O. . 0001. AETNA If!:. · 00000 13-36707!6 . . 0 ............... O.
.. 0001 AETNA If!:. ........................... . . .. . ..... 00000 ..... 22-3187443. 0 ............... 0 ............... . . 0001. AETNA If!:. 00000. .. 57-1209768 ... 0 ..... .......... O. .. 0001 ... AETNA If!:. . ..... 00000 ..... 20-1274723. 0 . 0 .. . 0001 ... AETNA If!:. · 00000 ... 23-2871370. o ............ O. .. 0001 AETNA If!:. . ..... 00000 0 .. 0 ..
0001. AETNA If!: .. .... .... .13735 . 27.j)583973 ... 0 ..... .......... 0 .. . 0001. AETNA If!:. · ... 13174 26-2867560. o. . ....... O. . 0001 .... AETNA If!:. 00000 ..... 47-5178095 ... 0 . ..... 0 ............... . .. 0001 ... AETNA Ire. . ..... .14043 .. 27-2512072 ... 0 ............... 0 .. . . 0001. AETNA Ire. ................................ . .. ...... .15805 ..... 47-3850677.. 0 ............... 0 .. 0001 ... AETNA If!:. 15616 81)-0629718. 0 ......... O.
.. 0001 ... AETNA Ire. . ..... 00000 . 80-0671703. 0 .. 0 0001. AETNA Ire. · . .14229. .. 25-2764938 ... 0 ............... O.
.. 0001. AETNA Ire. . ............... 15611 ..... 46-3203088. 0 . 0 . 0001 .... AETNA Ire.
.. 0001. AETNA Ire. 0001 .... AETNA Ire.
. 0001. AETNA Ire.
· . .15919 ..... 81-1143850 ... 0 . . 0 00000 . 04-27001110. 0 ............... 0 00000 73-1702453. 0 ............... O.
...... 00000 ..... OHJ826783 ... 0 . 0 0001. AETNA Ire. . ....... . ..... 00000 ..... 86-lJ842559. 0 . 0
. 0001. AETNA Ire ......................... . · . 00000. 45-2944270. 0 ............... O. . 0001. AETNA Ire .. ...... 00000 ..... 16-1471176 ... 0 .............. 0... . 0001. AETNA Ire ....................................... . ...... 00000 ..... 45-4901541. 0 ............... O. 0001 ... AETNA Ire. · .. 00000. 45-5527797. 0 . 0
.. 0001. AETNA Ire .. · . .15097. 46-0674828 ... o. . ... 0 . 0001. AETNA Ire. ..... .15098 ..... 46-0682197. o. . ....... O.
. 0001 AETNA Ire . ...... 00000 ..... 81-3789357 ... 0 ............... O.
0001. AETNA Ire. ..... ..16121 ..... 81-4749336 ... 0 ............... 0 .
.. 0001 . AETNA If!: .. ...... 16132 ..... 47-5548221 . 0 0
.. 0001 . AETNA If!: . . 95109 ..... 23-2169745 . O. O. . 0001 AETNA If!: .. ...... 00000 ..... 45-4901541 ... 0 . O. .0001 AETNA If!:. . 00000 ..... 21Hl438576 . 0 0
7
Name of Securities Exchange
if Publicly Traded (U.S. or
International)
8 9 10
Relation-Domi- ship
11 12 Type
13 If
14
Names of ciliary to Parent, Subsidiaries Loca- Reporting " Directly Controlled by
Or Affiliates tion Entitv IName of Entitv/Perso·n)
of Contra I (Ownership,
Board, Management,
Attorney-in-Fact, Influence,
O1her)
Control is
Ownership
Provide Percen
taoe Ultimate Controlli~~ Entitv(ies)!PersonlsJ
Aetna IrK:. __ Pk. VIP. ___ Aetna Inc .. Aetna Health ftlldings, lie ... CE. ........... J.[P... Aetna Inc. _ Ollnership._ Aetna Health of California Inc. .CA. ............ IA. ....... Aetna Health Holdings, UC ...................... Ownership .. Aetna Health Inc. . ................. CT.. IA. Aetna Health Holdings, UC OwnerS-lip .. . Aetna Health Inc. .FL ............ IA. ....... Aetna Health Holdings, UC ...................... Ownership .. Aetna Health Inc. . .GA.. IA. ....... Aetna Health Holdings, UC. Ownership .. Aetna Health Inc. . .......... I.E.. . ...... IA. Aetna Health Holdings, UC. . . Ownership .. Aetna Health Inc. . .... MI ............. IA... Aetna Health Holdings, UC. . Ownership. Aetna Health Inc. .. .N.J. IA.. Aetna Health Holdings, UC Ownership .. Aetna Health Inc. . .m . ............ IA. ....... Aetna Health Holdings, UC. . ... Ownership .. . Aetna Beller Health Inc. .NY IA. ....... Aetna Health Inc. lNY) ........... Ownership .. . Aetna Health Inc. . . .......... TX... . ...... IA. Aetna Health Holdings, UC. . . Ownership .. . Aetna Better Health of Texas Inc. . .Tx.. IA. ... Aetna l1:!alth Holdings, UC ... Ownership .. . Aetna Beller Health Inc. . . ................ GA... IA. Aetna Health Holdings, UC Ownership .. . Aetna Dental of California Inc.. . .. CA.. IA. ....... Aetna Health tbldings, liC .................. Ownership . Aetna Dental Inc. . .~ IA. Aetna Ii3alth Holdings, liC .. Ownership ... Aetna Dental Inc. . .TX. ............ IA. ....... Aetna Health Holdings, UC. Ownership . Aetna Ax tbne Delivery, liC. . . .IE. NIA. Aetna Health Holdings, llC Ownership .. . Aetna Health Management, liC ............... CE.. . ..... NIA. ... Aetna Health Holdings, liC ... Ownership .. . Aetna Ireland Inc. . .CE... NIA... Aetna Health Holdings, liC Ownership . Aetna Specialty Pharmacy, liC. . .. CE... NIA ..... Aetna Health Holdings, LLC Ownership_ .. Cofinity, Inc. . ..CE.. . .... NIA... Aetna Health Holdings, liC. Ownership . ICredentials Inc. . . .......... CE. ........... NIA. .... Aetna Health Holdings, liC. Ownership .. . Aetna Services (Thailard) Limited _______ .. __ . ____ J1i\ .......... NIA... Health Care t.1ana~t Co. LId. . . O.nership . Aetna Better Health Inc. . ............ PA... IA. Aetna Health Holdings, liC O.nership .. . Aetna Better Health Inc. . .CT. ............ IA... Aetna Health 1"01 dings , liC. O.nership .. . Aetna Better Health of California Inc.. ..CA. IA. Aetna Health 1"01 dings , liC O.nership . Aetna Better Health Inc. . .IL. . ..... IA. ....... Aetna Health I'kll dings , liC. Ownership .. . Aetna Better Health of Iowa Inc. ..IA.. 1£ ....... Aetna Health I1:lI dings , liC. O,nership_ . Aetna Better l-1!alth, Inc. . .. LA. ............ IA... Aetna Health I"oldings, liC. O.nership .. . Aetna Florida II'(;. ..FL .......... NIA... Aetna Health Holdings, lie. O.nership_ .. . Aetna Better Health Inc. . ............ CtL. IA Aetna Health Holdings, lie Ollnership ... Aetna Better l-1!alth Inc. . .NJ_ IA ....... Aetna Health I-klldings, lie Ollnership_ .. Aetna Better Health of Oklahcrna Inc. . .CK._. IA. Aetna Health Holdings, lie. Ollnership_ . Aetna Student Health Agency Inc. JM.. . .. NIA. ...... Aetna Health Holdings, liC. . Ownership .. Delaware Physicians Care, Incorporated. . .. CE.. IA.. Aetna Health Holdings, lie. Ownership_ Schaller Anderson Medical Ad'ninistrators, Incorporated .. .1£. NIA_ . Aetna Medicaid Altninstrators lie . . f!.l.... NIA iTriage, liC. CE. NIL Prodigy Health Group, Inc. CE. .......... _NIA. Aetna AGO I-klldings, Inc. .CE. .......... NIA. .. Imovation Health Holdings, liC .................. CE ........ NIA .. Imovat ion Heal th Insurance COOflany ......... VA... IA._. Imovation Health Plan, Inc. .VA. __ ........ IA._. Texas Health + Aetna Health Insurance I1llding COOllany liC . T~ ........... NIL Texas Health + Aetna Health Insurance ~any
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.. AetrB Health rbldings, lie. . ........ Ownership_ Aetna Health Itlldings, liC. . .. Ownership ...
.. Aetna AGO I1lldings, Inc.. . ................... Ownership_ Imovation Health Holdings, liC ... Ownership .. Imovation Health Insurance Company .......... Ownership .
Aetna AGO I"oldings, Inc. . ...................... Ownership . Texas Health + Aetna Health Insurance I"olding COO'fIany LLC . Texas Health + Aetna Health Insurance
Ownership
~any . O,nersh i p Aetna Health tbldings, LLC O,nership_
. . Aetna Health Inc. (PA) .. __ ........................ Ownership_ ..... . Prodiav Health Group, Ill::. . ......... O'nership .. _.
. . 0.000. 100.000 Aetna Inc .. 100.000 Aetna Inc . 100.000 .... Aetna Inc ..
. ... ::::::::: ~ ~::: ::: ::~~ :~: 100.000. Aetna Inc. 100.000 ... Aetna Inc. 100.00:.> ___ Aetna Inc. 100.000 . __ . Aetna Inc.
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.... 1-100.000 . Aetna Irx: .. . 100.000 .... Aetna Inc.
100.000 Aetna Irx: •. 100.000 Aetna Inc. 100.000 . Aetna Inc •. 100.(0) .... Aetna Inc. 100.000 .... Aetna Inc.
....... _100.000 ___ Aetna Inc. 100.000. Aetna Inc.
.............. _100.000 ___ Aetna Inc .. 100.000. Aetna Inc.
_100.000 .... Aetna Inc. . _100.000 Aetna Inc.
100.000 .... Aetna Inc. .. ..... _100.000. Aetna Inc ..
_100.000 .... Aetna Inc .. _100.000 .. Aetna Inc ..
100.000 Aetna Inc .. _100.000 .... AetrB Inc.
. .... _100.000 .... Aetna Inc .. . .................. 1-100.000 .. Aetna Inc •.
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. 0.200 ..... Aetna Inc .. ....... _.50.000 Aetna Inc •.
' .. 1-100.000. Aetna Inc .. 100.000 .... Aetna Inc .
Aetna Inc ......................................... .
..... _100.000. Aetna Inc.
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......... +.39.500 .... A,t", Inc .. 100.000. Aetna Inc ..
15 16
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STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y PART 1A DETAIL OF INSURANCE HOLDING COMPANY SYSTEM
2 3 4 5 6
NAIC Group Company 10 Federal Code Group Name Code Number RSSD CIK
.. Il001 .... IElIl\ I~. Il001 .. IElIl\ I~ .. Il001 .. IElIl\ I ~.
.. Il001. IElIl\ I~. . Il001 ... IElIl\ I~. Il001. IElIl\ I~.
.. Il001 .... AETNI I~ ..................................... .
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. .. IIOOIlO .... 1&-1684061 ... O. . O.
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.. Il001 .. IElIl\ I~ .................................. . ...... 68500 ..... 62-1181209 ... 0 . 0 ............... .
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.. Il001. IElIl\ I~. . ..... 36153 . 0&-1286276 ... 0 ............... 0..
.. Il001 .... IElIl\ I~. . .... 1IOOIlO ..... 0&-11128469 .. 0 . 0 ............... . Il001 IElIl\ I~. 1IOOIlO. 0&-1373153. 0 ....... O.
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.. Il001 .... IElIl\ I~. . ..... 1IOOIlO ..... 511-2100747 ... 0 . 0
. Il001. IElIl\ 1ft. IIOOIlO . . ................ 0 . . 0001552250
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.. Il001. IElIl\ I~. . . ..... 1IOOIlO ..... 33-0052273 .. 0 ......... 0 Il001 .. AETNI 1ft. . .1IOOIlO .... 75-2420973. O ............. O.
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Il001 .... 1ElIl\ I~. . IIOOIlO ..... 91-1774434. 0 ............... O. Il001. IElIl\ I~. . ..... 78700 ..... 0<HI876836 .. O ............. O.
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. Il001 ... AETNI I~. . ..... 1IOOIlO ..... 98-0211470 ... 0 ............... O. Il001 AETNI I~. . .1IOOIlO 0 . 0
.. Il001. AETNI I~. . ..... 00000 . 0 ............... O. .Il001 .... AETNI 1ft. . IIOOIlO ... . 0 0 .
.. Il001. AETNI 1ft. . .. 1IOOIlO. . ........ 0 .............. O.
.. Il001 .... IElIl\ I~. . . .... 1IOOIlO .. . ................ 0 0 Il001. AETNI 1ft. . ..1IOOIlO . 0 0
7
Name of Securities Exchange
if Publicly Traded (U.S. or
International)
8 9 10
RelationDomi- ship
Names of ciliary to
11 12 Type
of Control (Ownership,
Board, Management,
Attorney-in-Fact.
13 If
Control is
Ownership
Provide
14
Parent, Subsidiaries Loca- Reporting IIDirectly Controlled by Influence, Other)
Percen- Ultimate Controlling Or Affiliates tion EntiN Name of Entitv/Person)
Performax, Inc. .[E. NIA- ___ Prodigy Health Group, Inc ........................ Ownership_ Scrip World, Lie. Ul.. . ..... NIA. ...... Prodigy Health Group, Inc. _ Ownership .. . Precision Benefit Services, Inc. ___ ._____________ [E_ NIA. ..... Prodigy Health Group, Inc. __ Ownership .. . American t-Eallh Itllding, Inc. . .......... CtL .......... NIA. Prodigy Health Group, Inc.. . ................ Ownership ... . Meritain Health, Inc. . ~.. NIA. ...... Prodigy Health Group, Inc. . . .... Ownership .. . Ad'ninco, Inc. .~.. NIA. ... Aetna Health Itlldings, llC. Ownership Ad'ninislrative Enterprises, Inc. . ... fJJ... •.••.•••••• NIA. ...... Meritain Health, Inc.. Ownership . U.S. t-Ealthcare Itlld ings , llC Ctt. ..... NIA. ...... Meritain Health. Inc. Ownership .. . Prime Net, Inc. . .......................... CH NIA.... Meritain Health, Inc. . Ollnership Professional Risk Management, Inc. .............. CtL NIA. ..... Meritain Health. Inc. . . Ownership .. . Continental Life Insurance CO!TJlany of Brentwood, Tennessee .. . .. TN. ........... IA ....... Aetna Inc. . ................. Ownership
Continental Life Insurance ~any of American Continental Insurance ~any. . .. TN. ............ IA.. Breohrood, Temessee ........................... Ownership Aetna Life Insurance ~any . .CT. IA. Aetna Inc, ... Ownership .. Aetna f.CO Itlldings, Inc ............................. CE.. . ..... NIA. ... Aetna Life Insurance Ccln"pany . Ownership At-P Itlldings, Inc. CT. NIA. ...... Aetna Life Insurance Coo'pany Ownership .. . Aetna Insurance COO1pany of Comecticut. . .. CT. ........... IA.. ,aw rbldings, Inc.. . ............................ Ownership .. AE Foorteen, Incorporated. . .. CT. ........... NIA. ...... ,aw Itlldings, Inc. . . ....................... Ownership_ . Aetna life Assigment Ccln"pany . .C1.. .. NlA. . __ ,aw rbldings, Inc. . . Ownership .. PE Itlldings. liC ... CT. ........... NIA. __ Aetna Life Insurance CoIrlIany . Ownership_ Aetna Resources L.L.C. . .CE.. NIA. __ ... Aetna Life Insurance ~any Ownership ... Canal Place, liC.. . .. CE.. ........... NIA. ...... Aetna Life Insurance Carpany ................. Ownership_ Aetna Ventures. liC. CE. NIA. ..... Aetna Life Insurance Corrpany .. Ownership ... Broadspire National Services, Inc. ...FL ........... NIA. ...... Aetna Life Insurance Carpany .................. _. Ownership_ . Aetna t.tJlti-Strategy 1009 Fund, liC .CE..... . .. NIA. ...... Aetna. Life Insurance Ccln"pany .................. Ownership_. Aetna Financial Itlld ings , llC. ...CE. ........... NIA. . __ Aetna Inc. . .. Ownership_ .. Aetna Asset Advisors, llC. .[E. __ .. NlA. .... Aetna Financial Holdings, liC Ownership_. U.S. Healthcare Properties, Inc.. .PA.. NIA. __ .. Aetna Financial I-bld ings , liC Ownership ... Aetna Capital Management, liC. [E .......... NIA. ..... Aetna Financial Holdings, liC. Ownership_. Aetna Partners Diversified Fund, liC CE. NIA. .. Aetna Capital Management, liC _. Ownership ... Aetna Workers 1 Corrp Access, liC ____ ... _ ... LE ........... NIA. ...... Aetna. Financial Holdings, liC. Ownership ___ Aetna Behavioral Health, liC. CE.. NIA. __ . Aetna. Financial Holdings, liC Ownership ... Managed Care Coordinators. Inc. .. ............ CE. ........... NIA._ .. __ Aetna Financial Holdings. liC Ownership_ .. !-brizon Behavioral Services. liC. .CE.... MA. __ .. Aetna Financial Holdings, LLC Ownership_. ~Ioyee Assistance Services, LLC. . .... KY. ........... NIA. ...... !-brizon Behavioral Services, liC Ownership_ . Hea Ith and Ii.Jrran Resource Center, Inc. . CA. . IA. ....... !-br izoo Behav iora I Serv ices. liC . Ownersh ip ___ Resources for Living. liC ... Tx.. ._ ... _ ..... NIA. __ .. !-brizon Behavioral Services, LLC Ownership .. . The Vasquez Gr~ Inc. . .. IL ........... NIA.. !-brizon Behavioral Services. LLC Ownership .. . Work and Family Benefits. Inc. . ~L NIA. __ .. I-1Jrizon Behavioral Services, liC Ownership_ Aetna Card Solutions, LLC. ..CT. ........... NIA. ... __ Aetna Financial HoldirYils, LLC Ollnership_. PayFlex f-bldings. Inc. . .CE. .......... NIA.... Aetna Financial Holdings, LLC Ownership_ PayFlex Systsns I..SA, Inc.. ...~. NIA. __ . PayFlex Holdings. Inc. Ollnership .. Aetna t-Ealth aoo Life Insurance Corrpany .......... CT. ...... _ .... IA Aetna Inc. Ownership. Aetna Health Insurance Co-llJany. PA. IA. ...... Aetna Inc. . Ollnership ... Aetna IUlth Insurance Carpany of Nell York ... ... m ............. IA ....... Aetna Inc. Ownership. Aetna International Inc. CT... ...NtA ...... Aetna Inc. __ . __ . ________ . __ . Ollnership ... Aetna Life & Casualty (Bermuda) Ltd. . ...BW ............ IA ... Aetna International Inc. . ......... Ownership. Aetna Insurance (Singapore) PTE. LTD. . ..SIP . ........... IA ....... Aetna International Inc. Ownership .. . Aetna Global Benefits (Bermuda) Limited ......... 00 .......... NIA.. Aetna International Inc ....................... Orrnership Goodlealth Worldwide (Global) Limited. . . BIlL NIA. Aetna Global Benefits (Bernuda) L mited . Orrnership ... Aetna Global Benefits (Europe) Limited .. 1lR .......... NIA. Aetna Global Benefits (Bermuda) L mited. Ownership Goodlealth Worldwide (Asia) Limited .............. J·KG.. NIA. Aetna Global Benefits (Bernuda) L mited . Ownership .. _._. Aetna Global Benefits Limited .............. .AFE .......... NIA. Aetna Global Benefits (Bernuda) L mited __ . Ownership .. ..
tace Entitv(ies)/Personisl . .......... _100.000.. Aetna Inc .
100.000 .... Aetna Inc .. 100.000 .... Aetna Inc.
........... 1-100.000 ___ Aetna Inc. 100.000 _ ... Aetna Inc .. 100.000 ___ Aetna Inc .. 100.000. Aetna Inc .. 100.000 .... Aetna Inc .. 100.000 _. Aetna Inc. 100.000 .... Aetna Inc.
100.000 ._ .. Aetna Inc.
100.000 Aetna Inc. 100.000 Aetna Inc .. .60.300 _. Aetna Inc ..
:.::::::::::::::::::~~::: .... ::~: ::: 100.000 __ . Aetna Inc. 100.000 Aetna Inc .. 100.000 __ Aetna Inc .. 100.000 .... Aetna Inc. 100.000. __ Aetna Inc.
.. ...... 1-100.000 ... Aetna Inc. . 100.000. Aetna IrK:.
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. .... _100.000 ._ .. Aetna Inc. _100.000 .... Aetna Inc ..
100.000. Aetna Inc. ........ _100.000 ___ Aetna Inc.
_100.000 Aetna Inc .. . _100.000 .... Aetna Inc.
_100.000 .... Aetna Inc. .... ..... _100.000 . __ Aetna Inc ..
_100.00t? ___ Aetna Inc .. _100.000 __ Aetna Inc .. _100.000 .... Aetna Inc. _100.000 ___ Aetna. Inc ........................................ .
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15 16
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STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y PART1A DETAIL OF INSURANCE HOLDING COMPANY SYSTEM
2
Group Code Graue Name
. ~0001 ~
~ 0001 IETtl\ I~. ~
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Code
4
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~~~~~95925 ~ ~ 42-1_ ~ 0 ~ 0 ~
.0001 IETtl\ I~. ~~~~~~~~~~~~~~~~~~~~~.~~~~~~~~~~~~~~~~~ .. ~ .. ~OOOOO ~~~~~ 47-2Q49117 ~ 0 o ~
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7
Name of Securities Exchange
if Publicly Traded (U.S. or
International}
8 9 10 11 12 Type
of Control (Ownership.
Relation-Domi- ship
Names of ciliary to Parent, Subsidiaries Loca- Rep~~ing "Directly Controlled by
Or Affiliates tion Entitv (Name of Entity/Person)
Board, Management,
Attorney-in-Fact, Influence,
Other) PT. Aetna Global Benefits IrKIonesia ........ .IeN. .......... NIA. ...... Aetna Global Benelits (Berm) Limited. Ownership .. . Aetna Global Benefits (Middle East) tiC ....... AFE... NIA.... Aetna Global Benefits (Berrruda) Limited ... Ownership .. . Aetna Global Benefits (Asia Pacific) Limited
Spimaker Tepeo Limited. Spimaker Bioco Limited . Aetna f1lldco (LK) Limited PT Asuransi Aetna Asia. Aetna Global Benefits (LK) Limited Aetna Insurance Gcrnpany Limi ted ...
lroian Health OrganisatiCrl Private Limited. Aetna Hea I th Insurance Ct:rIl'any of Europe DAC
Aetna (Shalllj"lai) Enterprise Services Co. Ltd.
.. H<G. .......... NIA... Aetna Global Benelits (Berm) Limited. O"nership .. .BW NIA. Aetna Global Benelits (Berruda) Limited · Ownership .. .GlfL NIA. Spimaker Topeo Limited. O"nership .. . .GBF!... NIA... Spimaker Bioco Limited. Ownership .. .
. .leN.. NIA. ..... Aetna International Inc. Ownership .. .
.. .GIR .......... NIA... . Aetna I-klldco (LK) Limited.
. .GIR.. . .. .IA.. Aetna Holoco (LK) Limi ted ~~~~~~~~~~~.~~~~~~~~~~~.
Ownership .. O"nership ...
If{)~ ~~~ ~~~~~ ~NIL
~..IIL ~~~ ~~.~~~~.IL
~.lffi ~~~ ~~ .. ~~~NIL
Aetna Global Benefits (Asia Pacific) Limited . Ownership ..
Aetna International Inc. . .................. O"nership .. .
Aetna International Inc ........................... O"nership. Aetna (Beijing) Enterprise Managenent Aetna (Shall;tlai) Enterprise Services Co . Services Co., Ltd. . . .o-N. .......... NIA. ...... Ltd. . ........................... Ownership_ Aetna Global Benefits (Singapore) PTE. LTD ... ~ ........... NIA. ...... Aetna International Inc. . ...... O"nership_
Aetna Global Benefits (Singapore) PTE, LTD.
13 14 H
Control is
Ownership
Provide Percen-
1aoe Ultimate Controlling En1ilvliesliPerson(s)
lIl.ooo ~
49.000 .~~~
Aetna Inc .. Aetna Inc.
100.000 .... Aetna Inc. 100.000. Aetna Inc .. 100.000. Aetna Inc. 100.000 .... Aetna Inc .. n.rXJJ Aetna Inc. 100.000 Aetna Inc. tOO.OOO ___ Aetna Inc ..
D.02O .... Aetna Inc.
. ....... 1-'00.000 .... Aetna Inc.
100.000 __ . Aetna loc.
100.000. Aetna Inc. 100.000 .... Aetna loc ..
.................... j--.99.9al Aetna IrK: .. _ 100.000 .... Aetna Inc .
Ownership_ .. .. ... ... ... Ownership ...
Indian Health Organisation Private Limited ..... .INl ......... NIA. .. AI..ISI-C I-bldings, Inc. . CT. NIA.... Aetna Inc .. Aetna Globall-klldings Limited . f.i[f!. .....••.. NIA. ...... Aetna International Inc •. ...... .......... Ownership_. Aetna Korea Ltd. . . .KCR.. . ... NIA. ...... Aetna Globall-bldings Limited ..... Ownership. Aetna Insurance (tb'lg Kong) Limited. . ........ H<G. .......... NIA... Aetna Globall-klldings Limited. Ownersh ip_. Futrix Limited.. . NZL .......... NIA. ...... Health Data & Managanent Solutions, Inc.. Ownership_. PI-PStE Parent Corporation. ..JE. ........... NIA. ALS:-t I-bldings, Inc .. Active Health ll'enagement, Inc. CE. .NIA. ..... Aetna Inc .. Health Data & IItulagement Solutions, Inc. . ..CE. ... NIA._ ... Active Health Management, Inc • Aetna Integrated Informatics, Inc. PA.. . ... NIA. ...... Active Health Manage-neot, Inc. f-ealth Re, Inc. . VL ........ IA_ ...... Aetna Inc. Phoenix Data Solutions liC. . .. CE. ........... NIA. ...... Aetna Inc. Healthagen tiC . CT. ... NIA.. Aetna Inc .. ASI Wings, tiC ... CE. ........... NIA... Aetna Inc. Echo Merger Sub, Inc. CE. ... NIA.. . Aetna Inc. Aetna Corporate Services. tiC ... CE. ........... NIA. ...... Aetna Inc. Coventry Health and life Insurance Coo"pany. 1(1.. ••.. IA. ....... Aetna Health I-klldings, LLC ... .
O"nersh ip_. · Ownership .. .
...... Ownership .. . Ownersh ip_
..... Ownersh ip .. Ownership_
· Ownership ... . . Ownership.
Ownership_ . . Ownership.
Ownership. Aetna Better Health of Kentucky Insurance Coventry Health and Life Insurance C~any Coovany . Group Dental Service, Inc .. Group Dental Service of Maryland, Inc. Aetna Nehork Services tiC ._. Aetna Health of Iowa Inc. Coventry Health Care of Nebraska, Inc. Aetna Risk Assurance CCflllany of CCrlnecticut
.~~KY~ ~~~~ ~~~~~~~.IL Ill ... NIA. ... Aetna Health I-klldings, liC
.. 1() ............. IA. ...... Gro,"" Dental Service, Inc .. CT. .... NIA. ...... Aetna Health I-klldings, liC.
... IA. ............ IA.. . Aetna Health I-klldings, liC. M:. ............ IA... Aetna Health I-klldings, liC.
Ownership .. Ownership_ .. Ownership . Ownership .. Ownership .. Ownership_.
Inc. . . ...... CT. ........... IA.. Aetna Health I-klldings, LLC Ownership .. Aetna Health Inc. LA. ..... IA. ....... Aetna Health I-bldings, liC ~.~~~~~~~~~~~~~~~~. IOwnership .. . HealthAssurance Pemsylvania, Inc. . .. PA. ............ IA_ ... _. Aetna Health I-klldings, LLC. Ownership_. Coventry PrescriptiCrl Management Services, Inc .. . ... f'II . ........... NIA. ...... Aetna Health I-klldings, liC ..................... Ownership .. . Aetna Better Health of Nevada Inc .. Coventry Health Care of Virginia, Inc. Coventry Transplant Nehork, Inc .......... . Coventry Health Care 01 Missouri, Inc ..
... f'II. IA. Aetna Health I-klldings, liC. . ... O"nership .. .
. .. VA. ............ IA. ....... Aetna Health I-klldings, LlC. . O"nership .. .
.. JE... NIA.... Aetna Health I-klldings, liC. . Ownership ..
... K1.. .......... IA.. Aetna Health I-klldinas, liC. . O"nership ... .
100.000 .... Aetna Inc . 100.000 .... Aetna Inc . 100.000 . __ Aetna Inc .. 100,000 .... Aetna Inc. _ ..55.000 . Aetna Inc ..
_______ 1-100.000 ... _ Aetna Inc. _ ___ _ 100.000 .... Aetna. Inc ... ~~~~~.~~~~.~~~ .. ~~~ ... ~~~~~~~~~~~.~~
100.000. Aetna Inc. _ 100.000 ... Aetna Inc. _ 100.000 ___ Aetna Inc .. 100.000 .... Aetna Inc. 100.000 _ .. Aetna Inc .
............ 1-100.000 .... Aetna Inc. _ 100.000 ___ Aetna Inc . 100.000 ___ Aetna Inc.
100.000. Aetna Inc .. 100.000 .... Aetna Inc. 100.000 _ Aetna Inc ..
.. 1-100.000 ___ Aetna Inc .. 100.000 .... Aetna Inc. 100.000 ... Aetna Inc.
100.000. Aetna Inc. .... _100.000. Aetna Inc •.
100.000 .... Aetna Inc.
100.000 .... Aetna. Inc. . ....... _100.000. Aetna Inc ..
_100.000. Aetna Inc. ........... _100.000 Aetna Inc ..
100.000 ... Aetna Inc.
15
Is an SCA Filing Re-
quired? '(YIN)
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2
Group Code Group Name
.~oool ~ IE1N\ 1M:. 0001 IE1N\ 1M:.
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0001 IETfII I~.
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.. 0001 ~ AETN\ 1M:. ~oool ~ ~~ IE1N\ 1M:. ~ ~oool ~ AETN\ 1M:. ~
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0001 ~~~ IE1N\ 1M: .. .0001 ~~~~ IE1N\ 1M:. J)OOI ~~~~ IE1N\ 1M:. ~~oool ~ ~ IE1N\ I~. ~~oool ~.~ IE1N\ I~ ..
0001 ~ ~~ IE1N\ 1M:. ~~~~~~~~~~~~~~.~~~~~~.~~~~~~~~~~.~~~~~. ~~oool ~ . IE1N\ I~~ . ~oool IE1N\ I~. ~
0001 ~ IE1N\ I~.
~oool ~~~~ IE1N\ I~.
.~oool ~~~~ AETN\ I~. ~
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~oool ~ AETN\ 1M:.
0001 ~ AETN\ 1M:.
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y PART 1A DETAIL OF INSURANCE HOLDING COMPANY SYSTEM
3 4
NAIC Company 10
Code Number
5
Federal RSSO
~. 0 ~
o
6
CIK ~~.~~~95318 ~ ~ ~ 4>-1702094 ~~~ 0
95408 .~.~ 5>-0712129 ~. 0 ~~ ~ OOJOO .. 62-1411933 ~~~ 0 ~~ 0 ..
~ .. ~~J5827 ~~ 47-4352768 ~ 0 95489 ..... 48-0840330 ~ ~. 0 ~ ~ J6072 .. 81-3370401 ~~~ 0 .
~ .. ~~J2193 ~ 20-1052897 ~~ 0 ~~ ~ ~~~~95407 ~~~~~ 87-{)345631 ~~~ 0 ~~~
OOJOO 2O-441660L L 74160 ~ .~. 37-1241037 ~~~ O.
... ~ 0 ~
o ~ 0 ~
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.. ~.. 0 ~
0 ..
~ ..... OOJOO ~~~~~ 20-8070994 ~~ 0 ~~ 0 OOJOO ~ 20-5185442 ~~. 0 ~~~~.~~~~~~~~~ 0 ~
~~~~~OOJOO ~ 2&-1293m ~~ 0 ~~ ... ~.~ 0 ~
OOJOO ~ 20-8376354~. 0 ..... ~~~~.~~~. 0 ~
OOJOO ~ 20-4096903 ~~ .. ~ .. ~~~. 0 ~
~ j)OOOO ~ IJS-l095987 ~~~ 0 ~~ ~ 0
~~OOJOO ~ ~ 74-2879984 ~.~ 0 ~ ~ ~ 0
~OOJOO .. ~.~ 62-1286888 ~~~ 0 ~~ 0
. OOJOO ~.~.~ 87~~ ~ ~~~ ~ 0 ~ ~~~~~~OOJOO ~ ~~ 2O-1736437~~ .~~~~.~~~~.~~~~ 0 ~
Jl0328 ~ ~ 38-2242132 ~~~ 0 ~ ~~~ ~ 0 ~~~~~~~~~~~~~~~~ .~~~~.OOJOO ~~~~~ 52-1320522~ 0 0 ~
OOJOO ~ .. ~. 20-1130063 0 ~~~~~~.~~~~~~~. 0 ~.~~~~95114 65-0086441 ~~ 0 .. ~~ O.
95266 65-0453436 ~ ~. 0 0 ~ OOJOO ~ ~ 59-37lO548 0 ~~~~~~ .. ~~.~~~~ 0 ~ OOJOO ~~.~~ 36-4391310 ~~. 0 0 ~
~~~~~~OOJOO ~ 0 ~~~ .... ~ .... ~~ 0 ~ ~~~~~~OOJOO ~ ~ 2&-1582982 ~ 0 . ~~ O.
~ OOJOO .. 37-1448700 .0. 0 ~~~~.~~~~~~~~~~~ = ~~~~~ ~~= ~~~ : ~~.~~ ... ~~~~ ~~ : ~ .... ~ .. ~ ...... ~ . ~ ~~~OOJOO ~ 20-4276336 ~~ 0 .~~.~~ 0 . ~~~~~~~16242 ~ 81-5030233 ~~ 0 ~~ 0 .
OOJOO ~ .. ~~ 81-5212760 ~~. 0 . ~~ 0 ~
16058 ~.~~~ 81-5281115 ~~~ 0 .~~~~~~~~~~~~~~ 0 ~
.. ~~~~16059 ~~~~~ 81-5290023 ~~ 0 ~~ ~~~~~~ 0 ~
. ~~~~~OOJOO ~~ ~~ 81-511288L L ~ 0
~~~~~J6194 ~.~~. 82-2091197 . 0 ~~~~~~~~~~~~~~~ 0 ~~~~~~~~~~~~~~~~
~.~~~~OOJOO ~~ 82-2171057 ~~~ 0 ~~~~~.~ .. ~~~ ~ 0
7
Name of Securities Exchange
if Publicly Traded (U.S. or
International)
8 9 10 11
Relation-Domi- ship
12 Type
13 If
Control is
Ownership
Provide
14
Names of ciliary to Parent, Subsidiaries Loea- Rep~~ing Directly Controlled by
of Central (Ownership,
Board, Management,
Attorney-in-Fact, Influence,
Other) Percen- Ultimate Controlling
taoe Entitvlies)/Person(s) Or Affiliates tion Entitv (Name of Entity/Person) Aetna Belter iUlth of Missouri liC .... Kl ............ IA. .. __ Aetna Health I-klldings, lie. _ Ownersh ip .. Coventry Iiilalth Care of West Virginia, Inc. _WL IA ....... Aetna Health I-klldings, LlC. . .......... Ownersh ip_ Coventry li9althCare t.1anagErnent Corporation _ __CE_ NIA ...... Aetna Health I-klldings, LlC_ ...... Ownership. Aetna. HeatthAssurance Pemsylvania, Inc. . .. PA. ........... IA Aetna Health I-klldings, LlC. Ownership_ Coventry li9alth Care of Kansas, Inc. _KR tA ...... Aetna. Health I-klldings, LlC_ .. Ownersh ip .. . Aetna. BeHer Health of Kansas Inc. . _KR IA Aetna Health I-klldings, LlC Aetna Belter I1ealth of Michigan Inc. MI... ..... IA.. Aetna Health I-klldings, LlC . Aetna Health of Utah Inc. . _Uf__ _ _ IA ....... Aetna. Health I-klldings, LlC. Aetna. BeHer I$.lth Inc. . ..... TN. ........... NIA.__ Aetna Health I-klldings, LlC . __ _ Coventry li9alth Care of Illinois, Inc.. _-'L _______ IA ..... Aetna. Health I-klldings, LlC_ Coventry I$.lth Care National AccolJ'lts, Irx:.
CE. . .... NIA. ...... Aetna Health I-klldings, LlC. Coventry li9alth Care ~tlonal Network, Inc. . .. CE.. .NIA. Aetna Health I-klldings, LlC
Ownersh ip .. . Ownership_ Ownership_ Ownership ... Ownership ..
Ownership Ownership ...
Coventry CCIlSU'IIer Advantage, Inc .. ~~~~~~~~~~~~~ I .CE ........... NIA... Aetna Health I-klldings, LlC. __ _ ___ Ownersh i p._ Covent ry Hea I th Care Workers Coopensat ion, Inc. . ..... CE. ........... NIA. __ _ Aetna Health I-klldings, LlC. Ownership ...
Coventry li9alth Care Workersl C~ensation, First Script Nehork Service, Inc. ~ .. ~~~ ~~~ ~~~~~~~NI' Inc. _ Ownership.
Coventry Health Care Workers I C~ensation, II1etraCoop, Inc. ~ ... ~~~~ ... ~~ ~~~CI Nile Inc. . ____ Ownership ...
Coventry li9alth Care Workers I C~ensation, Medical Examinations of New York, P.C .. ~~~~~ Nile Inc. . . ...... Ownership __ _
Coventry Health Care Workers' Coopensation, FOCI.5 Healthcare Management, Inc .. ~TIL ~~ ~NIL Inc. . . ............ Ollnership_
Coventry li9alth Care Workers I C~ensation, Coventry Rehabilitation Services, Inc. _CE_. .. .. NtA. .. Inc. _ Ollnership __ _ First Health Group Corp. . ...... CE .......... _NIA. Aetna Health I-klldings, llC. _ Ownership ... First Health life & Health Insurance Ca'r1:lany
... TX. IA First Health Group Corp. .. .. Ownership __ Claims Actninistration Corp. t.t}___. NIA. ...... First Health Group Corp. . Ownership_ Florida Health Plan Actninistrators, liC. FL___ _ __ NIA... Aetna. Health I-klldings, liC ........... Ownership_ Coventry Health Care of Florida. Inc. FL ............ IA... Florida Health Plan Actninistralors, llC ____ Ownership .. . Coventry Health Plan of Florida, Inc ............. FL IA. Florida Health Plan Actninistralors, llC. Ownership __ . Carefree Insurance Services, Inc. ...FL ........... NIA. Florida Health Plan Adninistralors. liC __ . Ownership .. . bSllift LlC _ CE NIA. Aetna Health I-klldings, LlC ................... Ownership_ Virlual I-bne l-1:lalthcare l.l.C. .AF£. .......... NIA._. Aetna GloballtJldings limited ___ Ownership .. . tHEt Specialty Services, LlC _ t.t}_._ ...... NIA. ...... Aetna Health !-bldings. LlC. Ownership ... Mental Health Network of Nell York IPA. Inc ..... NY... NIA. ____ tHEt Specialty Services, LlC Ownership_ It-Net life and Health Insurance Coopany ....... TX. ......... _ .. IA.__ t.t-Net Specialty Services, LlC Ownership ... Mental Health Associates, Inc. LA. NIA... tHilt Specialty Services, liC Ownership_ r.t-Net of Florida, Inc. _ FL ............ IA... tHE! Specialty Services, ll.C. Ownership_ . Aetna Belter li9alth of Washington, Inc. _______ WA. ....... IA... Aetna t1lalth tbldings, ll.C _ . Ownership __ Bamer Health and Aetna Health Insurance !-bIding C~ny liC . __ Bamer Health and. Aetna Health Insurance C~any
IE. ........... NIA. _____ Aetna ACO tbldings, Inc .. Banner liea I th and Aetna tJea lth Insurance
f.il. .... ........ IA. ....... Holding Coopany ll.C Banner Health and Aetna tJealth Insurance
~~ AZ. .. ~~ .~~~~.~~1Ie ~~~~~~. Coooany ~
O,nership
Ownership
O,nership ... Barner l"ealth and Aetna Health Plan Inc. All ina Health ard Aetna Health Insurance tb I ding C~any liC ... CE ........... NIA. ...... Aetna ACO !-bldings, Inc. _______ Ownership .. .
Allina. Health and Aetna Health Insurance All ina Health ard Aetna Insurance C~any ______ 1rIN. ............ IA. .. tblding Company ll.C . Ownership ... Sutter l1:lalth ard Aetna Insurarx:e !-bIding
100.000 ... Aetna Inc .. 100.000. Aetna Inc.
....... _100.000. Aetna Inc. _ _100.000 .. Aetna Inc.
100.000. _ Aetna Inc. _ 100.000 .... Aetna Inc.
. ":':::::::::::I-~~:: ::: :::~ :~:. 100.000. Aetna Inc. 100.000 ___ Aetna Inc.
100.000 _ Aetna Inc. 100.000 .... Aetna Inc. 100.000 ... Aetna. Inc.
100.000 .... Aetna. Inc.
100.000 .... Aetna Inc.
...... 1-100.000 . __ Aetna Inc.
............ _100.000 Aetna Inc ..
100.000 Aetna. Inc ..
tOO.OOO .... Aetna. Inc. _ ........ _100.000. __ Aetna Inc.
_100.000 ___ Aetna Inc .. _100.000 .... Aetna Inc.
100.000 .. Aetna Inc •. _100.000 .... Aetna Inc. _
............ _100.000 ___ Aetna Inc. ......... _100.000 ___ Aetna Inc.
100.000 .... Aetna Inc .. _.49.000 . Aetna Inc. _100.000 .... Aetna. Inc.
............ _100.~ ___ Aetna Inc. ....... _100.000 ... _ Aetna Inc.
___ 100.000 _ . Aetna Inc .. _ _______ 100.000. Aetna Inc.
100.000 .... Aetna. Inc.
.51.000 ____ Aetna Inc.
100.000. Aetna Inc.
1-100.000. Aetna Inc ..
_.50.000 . Aetna Inc .
........ _100.000 Aetna Inc •.
~. ~~. ~~~~~~~ C"""nv liC ~~~~~~~~~~~~~~~~~~~~~~~~.~~~~ ~~.[E ~~~~ .~~~~.~NIL~ Aetna ACO !-bldinn.<. Inc. ....... Ownership .... .50.000 Aetna Inc ..
15 16
Is an SCA Filing Re-
quir~? ~(Y/NJ
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STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE Y PART 1A - DETAIL OF INSURANCE HOLDING COMPANY SYSTEM
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Type If
of Control Control (Ownership, is Is an
Name at Securities Relation- Board, Owner- SCA Exchange Domi- ship Management, ship Filing
NAIG if Publicly Traded Names of ciliary to Attorney-in-Fact, Provide Re· Group Company 10 Federal (U.S. or Parent, Subsidiaries Loca· Reporting Directly Controlled by Influence, Percen- Ultimate Controlling quired? Code Group Name Gode Number RSSD CIK International) Or Affiliates tion Entity (Name of Entity/Person) Other) laoe Entitv(iesliPerson(s) '(Y/N) .
Sutter l"ealth and Aetna Aministrative Sutter Health and Aetna Insural"K:e Itllding . JlOOl .... AElNI, Itc .. ..... JlOOOO . 82-2560624 .. o . ... O . Serv ices lie . .. IE .. ......... NIL .. ~any liC_ Ownersh ip_ ......................... _ 100.000 .... Aetna Inc .. .... N . .... ..... 0 ..
Sutter Health and Aetna Insurance Itllding 0001 ... AElNI, Itc .. 00000 .. 81-52'J0023 ... 0 . . -... -. 0 ................ Sutter t1lalth and Aetna Insurance C~any _____ C~ . NI~ ~any llC Ownersh ip ... _ 100.000 .... Aetna Inc. .... N .. 0.
.. 0001 .... AElNI, Itc. .. .... 00000 0 0 ............... Aetna H:Jldings (Thai land) limited ::-_~_~_. ______ . __ 1H1. ......... NIL Aetna Global !-bldings limited ................... Ollnership_ .................... _.49.000 . Aetna Inc. N .14 .... Aetna Health Insurance (Thai land) Publ ic
0001 AETl-I\ Itc. . 00000 . .... ..... 0 ............... O . C~any limited_ ................... ..1H1. .. NI~ Aetna Global !-bldings limited. __ Ollnership_ 25.000 Aetna Inc .. _ N . . ..... 15. Aetna Health Insurance (Thai land) Publ ic
0001 .. AElNI, Itc .. 00000 . 0 ... 0 ... C~any limited. - ----- . 1H1.. .. . NI~ Minor Health Entreprise Co, ltd. _____________ . Ollnership ... _.46.000 . Aetna Inc . ...... ~ .. 15 Aetna Health Insurance (Thai land) Publ ic
. 0001 .... AElNI, Itc. ...... 00000 . 0 . 0 Coof!any Limited. 1H1.. ... NIL Health Care Management Co. ltd. ................ Ollnership .. 28.000 Aetna Inc .. N 15.
.0001 ... AElNI, Itc. . 00000 . 0 . .............. O . Health Care Managenent Co. ltd. . ............. ...111\. .. NI~ Aetna Global !-bldings Limited. _ Ownership_ .49.000 . Aetna Inc. N. . .... .19 ..... 0001 ... AElNI, Itc .. .00000 . 0 ....... 0 Minor Health Entreprise Co, ltd •. .111\.. NIL Aetna Global !-bldings Limited ...... Ownership .. 25.000 Aetna Inc. ..... K .. .16 0001 AElNI, Itc. .00000 . o . . 0 Minor Health Entreprise Co, ltd •. ..111\. .. NI~ Aetna !-bldings (Thai land) limited .. Ownership ... ----- _.75.000 .... Aetna Inc. ..N ..... .... .16 0001. AElNI, Itc ... . ..... 00000 . o ............... O. Health Care Managenent Co. ltd .. __ .. 111\.. NIL Aetna !-bldings (Thai land) limited . ............ Ownership_ _:1.000 Aetna Inc. ...... ~. .. 19
. 0001 AElNI, Itc .. 00000 . o ............... 0 Aetna Global Benefits (Bahamas) limited .JllfL NIL .. Aetna Global Benefits (Berrruda) Limited .. Ownership .. _100.000 . Aetna Inc. _ . .. .. N .. . 0. .. 0001 . AElNI, Itc. .... 00000 ..... . ................ o ........ O. Aetna Pharmacy Management Serv ices LLC ...IE ........... NIL Aetna Health !-bldings, LLC. _ Ownership 100.000 . Aetna Inc .. ... N .0 .
0001 AElNI, Itc. 00000 ... 82-3333789 . o . 0 Aetna Better Health of ~rth Carol ina Inc. .tc. I~ Aetna Health !-bldings, llC_ .. Ownership ... 100.000 . Aetna Inc. _ N ..... ..... 0 ...... Tianj in An Hai Tai tlJa Medical Information
0001 ... AETl-I\ Itc .. .. .. 00000 . 0.. O. Technology Co., ltd. J:It( . NIL Aetna International Inc . ............ Ownersh i p __ .50.000 .... Aetna Inc. ...... N .. .18
Asterisk Explanation 1. Aetna life Insurance Company, Aetna Health and Life Insurance ColTpany and Aetna Health Management, LLC own substantially all of the nOrHl\anaging merrbership interests .. 2 Indian Health Organisation Private Limited is 0.019857% owned by Aetna Global Benefits (Asia Pacific) am 99.900143% owned by Aetna Global Benefits (Singapore) PTE. LTD .. 3 . Aetna ActJ I-tlldings Inc. is owned by Aetna Life Insurance COlfllany (302 shares); Aetna Health Inc. (PA) (198 shares); am Aetna Health I-tlldings, LLC (I share). _ 4 PT. Aetna Global Benefits Indonesia is also 2Oro owned by Suhatsyah Rivai, Aetna's f'bminee. _ 5 Aetna Global Benefits (Middle East) LLC is also 51% owred by Euro (jjlf LLC, Aetna's Nominee .. 6. lmovation Health Holdings LlC. Is also 50% own&d by lrova Health System Follldation._ 7 pt..pgt.E Parent Corporation is 55% owned by AUSt«: Holdings, Inc. The remaining 45% is owned by thirteen different hospitals (non-affiliates) which are shareholders with varying degrees of ollnership .. 8. Medical Examinations of New York. P.C. is 10Cf1'0 owned through Aetna's nominees .. . ........
9. Texas Health + Aetna Health Insurance Holding Co~ny LLC is also 50% owned by Texas Health Resources .. 10. Bamer Health and Aetna Health Insurance ItJlding Corrpany UC is also 49% owned by Banner Health. 11 All ina Health and Aetna Insurance Holding Corrpany liC is also 50% ollned by Allina Health .. 12. Sutter Health and Aetna Insurance Holdirg Company LLC is also 50% owned by &Jtter Health Plan Products Organization, LLC. 13 PT Asuransi Aetna Asia is also 23% owned by PT Asuransi Central Asia. 14. Aetna I-tlldings (Thai land) limited is also 51% owned by Mr. Paiboon Sotantivorakoon plus Aetna. Global Benefits (Berllllda) limited Ollns 1 share. 15 Aetna Health Insurance (Thai land) Pub I ic Corrpany Limi ted is also ollned by Aetna Global Benefi ts (Berrruda) Limi ted (1 share), Mr. Sansanapongpherchar (1 share), Mr. Ji tphasong I tsaraphakded (1 share); Mrs. ~hee Wattana (1 share); and Mr. BLrlCha Tarrphragom (1 share) _ 16. Minor Health Entreprise Co, ltd is also (1 share) o1lned by Aetna Global Benefits (Berrruda) Limited. _ 17. Virtual Home Health Care L.L.C. is also 51% own&d by (3) Corrrnercial Brokers LLC .. ........................... 18. Tianjin An Hai Tai l1.Ja Medical Information TectrJology Co., ltd is also 50% owned by Tianjin Hai Tai Group Co., Ltd .. 19. Health Care Management Co. Ltd. Is also (1 share) ollned by Aetna Global Benefits (Bermuda) Limited .. ro. Aetna Services (Thai land) limited is also (1 share) owned by Aetna Global Benefits (Berllllda) Limited. _
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SUPPLEMENTAL EXHIBITS AND SCHEDULES INTERROGATORIES The 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 business for 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 supplement is required of your company but is not being filed for whatever reason enter SEE EXPLANATION and provide an explanation following the interrogatory questions.
Response
1. Will the Medicare Part D Coverage Supplement be filed with the state of domicile and the NAIC with this statement? ............................. . NO
Explanation:
1. Business not written
BarCode:
1. Medicare Part D Coverage Supplement [Document Identifier 365) n
17
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
Overflow Page for Write-ins
NONE Schedule A - Verification - Real Estate
NONE Schedule B - Verification - Mortgage Loans
NONE Schedule BA - Verification - Other Long-Term Invested Assets
NONE Schedule D - Verification - Bonds and Stock
NONE
18, SI01
en i5 I\)
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE D - PART 18 Showing the Acquisitions, Dispositions and Non-Trading Activity
D' h C Q B d d P IdS k b NAIC D unna t e urren! uarter lor all on san re errs toe )v esignation 1 2 3 4 S
Book/Adjusted Book/Adjusted Carrying Value Acquisitions Dispositions Non-Trading Activity Carrying Value
Beginning During During During End of NAte Designation of Current Quarter Current Quarter Current Quarter Current Quarter First Quarter
BONDS
1. NAIC 1 (al .. .... 1,094,925 3,373,230 ............. 3,373,999 ....... 5,242 1,091,429
2. NAIC 2 (al .. 0 ............. I 0
3. NAIC3 (al .. 0 0
4. NAIC4 (al ..... ... ... 0 0
S. NAIC S (al ......................... 0 ................. 0
6. NAIC 6 (al 0 0
7. Total Bonds 1,094,925 3,373,230 3,373,999 5,242 1,091,429
PREFERRED STOCK
8. NAIC 1 .. 0 ... 0
9. NAIC2 0 .... 0
10. NAIC3 .. . ................. 0 .0
11. NAIC4 .. ........... 0 0
12. NAICS .. . ......... 0 .. 0
13. NAIC6. 0 0
14. Total Preferred Stock 0 0 0 0 0
IS. Total Bonds and Preferred Stock 1,094,925 3,373,230 3,373,999 5,242 1,091,429
(a) Book/Adjusted Carrying Value column lor the end of the current reporting period includes the following amount of short-term and cash equivalent bonds by NAIC designation:
NAIC1 $ ..................... 1,099,398 ; NAIC2 $ 0; NAIC3 $ 0 NAIC4 $0; NAICS $ .. 0 ; NAIC 6 $ .. . .... 0
6 7 8 Book/Adjusted Book/Adjusted Book/Adjusted Carrying Value Carrying Value Carrying Value
End of End of December 31 Second Quarter Third Quarter Prior Year
1,094,925 1,099,398 ... 1,088,269
0 0
0 0
.. ...0 0 I ...... 0 ...... 0
0 0
1,094,925 1,099,398 1,088,269
... 0 .. 0 .0
.0 .. 0 .0
0 0 ......0
0 . ................ 0 . ........... 0
0 . . .......0 ......... 0
0 0 0
0 0 0
1,094,925 1,099,398 1,088,269
1.
2.
3.
4.
5.
6.
7.
B.
9.
10.
11.
12.
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE DA - PART 1
SCHEDULE DA - VERIFICATION Short Term Investments -
Book/adjusted carrying value, December 31 of prior year.
Cost of short-term investments acquired ..
Accrual of discount
Unrealized valuation increase (decrease)
Total gain (loss) on disposals
Deduct consideration received on disposals
Deduct amortization of premium ..
Total foreign exchange change in book/adjusted carrying value_.
Deduct current year's other than temporary impairment recognized
Book/adjusted carrying value at end of current period (Lines1+2+3+4+5-6-7+B-9) ..
Deduct total nonadmitted amounts
Statement value at end of current oeriod (Line 10 minus Line 11l
SI03
Interest Collected Year-ta-Date
1
YearTa Date
0
503,912
3,088
507,000
.................................. 0
0
Paid for Accrued Interest
2
Prior Vear Ended December 31
4,077
. .. 4,077
0
0
___________ c __ ~ ________ • _________________________ _
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
Schedule DB - Part A - Verification - Options, Caps, Floors, Collars, Swaps and Forwards
NONE Schedule DB - Part B - Verification - Futures Contracts
NONE Schedule DB - Part C - Section 1 - Replication (Synthetic Asset) Transactions (RSATs) Open
NONE Schedule DB-Part C-Section 2-Reconciliation of Replication (Synthetic Asset) Transactions Open
NONE Schedule DB - Verification - Book/Adjusted Carrying Value, Fair Value and Potential Exposure of
Derivatives
NONE
SI04, SI05, SI06, SI07
STATEMENT AS OF SEPTEMBER 30,2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE E - PART 2 - VERIFICATION (Cash Equivalents)
1 2
Prior Year Ended Year To Date December 31
1. Book/adjusted carrying value, December 31 of prior year _ . 1.0B9,725
2. Cost of cash equivalents acquired .. .. . ... .7.317.BI7 6.B44.564
3. Accrual of discount .. .......................... 10.517 5.455
4. Unrealized valuation increase (decrease) .. ........
5. Total gain (loss) on disposals
6. Deduct consideration received on disposals. ................ .7,317,979 5,760,294
7. Deduct amortization of premium .
8. Total foreign exchange change in book/adjusted carrying value
9. 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) . .. 1,100,OBO I,OB9,725
11. Deduct total nonadmitted amounts
12. Statement value at end of current oeriod (line 10 minus Line 11) 1,100,080 I,OB9,725
SI08
.-~,-.-... ------~.--------.---------------------
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
Schedule A - Part 2 - Real Estate Acquired and Additions Made
NONE Schedule A - Part 3 - Real Estate Disposed
NONE Schedule B - Part 2 - Mortgage Loans Acquired and Additions Made
NONE Schedule B - Part 3 - Mortgage Loans Disposed, Transferred or Repaid
NONE Schedule BA - Part 2 - Other Long-Term Invested Assets Acquired and Additions Made
NONE Schedule BA - Part 3 - Other Long-Term Invested Assets Disposed, Transferred or Repaid
NONE Schedule 0 - Part 3 - Long-Term Bonds and Stocks Acquired
NONE Schedule 0 - Part 4 - Long-Term Bonds and Stocks Sold, Redeemed or Otherwise Disposed Of
NONE Schedule DB - Part A - Section 1 - Options, Caps, Floors, Collars, Swaps and Forwards Open
NONE Schedule DB - Part B - Section 1 - Futures Contracts Open
NONE Schedule DB - Part B - Section 1 B - Brokers with whom cash deposits have been made
NONE Schedule DB - Part 0 - Section 1 - Counterparty Exposure for Derivative Instruments Open
NONE Schedule DB - Part D-Section 2 - Collateral for Derivative Instruments Open - Pledged By
NONE Schedule DB - Part D-Section 2 - Collateral for Derivative Instruments Open - Pledged To
NONE
E01, E02, E03, E04,E05,E06, E07, E08, E09
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
Schedule DL - Part 1 - Reinvested Collateral Assets Owned
NONE Schedule DL - Part 2 - Reinvested Collateral Assets Owned
NONE
E10,E11
..•• ---. -_._,----,--------------------------------------------
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE E - PART 1 - CASH Month End Depository Balances
1 2 3 4 5 Book Balance at End of Each Month 9 Durina Current Quarter
Amount of Amount of 6 7 8 Interest Received Interest Accrued
Rate of During Current at Current Depository Code Interest Quarter Statement Date First Month Second Month Third Month .
Bank of Amer i ca . Phoenix. AZ 0,000 10.000 . .10.000 .....10.100 XXX 0199998. Deposits in ... depositories that do not
exceed the allowable limit in anyone depository (See instructions) - Doen Deoositories XXX XXX XXX
0199999. Totals - Ooen Deoositories XXX XXX 0 0 10.000 10.000 10.100 XXX 0299998. Deposits in ... depositories that do not exceed the allowable limit in anyone depository (See instructions) - Suspended Depositories XXX XXX XXX
0299999. Totals - SusDended DeDositones XXX XXX 0 0 0 0 0 XXX 0399999. Total Cash on DeDosit XXX XXX 0 0 10.000 10.000 10.100 XXX 0499999. Cash in Company's Office XXX XXX XXX XXX XXX
.......... ..........
... ..........
. ·1 . ..... ........... -.-.- .. -......... ...
. ..... .............. .............................. . .........
........... .... . ... -.... ....
0599999. Total- Cash XXX XXX 0 0 10.000 10,000 10.100 XXX
E12
STATEMENT AS OF SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
SCHEDULE E - PART 2 - CASH EQUIVALENTS Show I Owned End of Curren: Quarter
2 3 4 5 6 7 8 9
GUSIP Gode Date Acouired Rate of In'., ... , r.;~~~'V~I~,e ~~~uan~d A~~~~:~t Amount ""'"ritvn"'e DurinQ Year
. .................. ".".,,; ........... . .. ~.: ; -Issuer' i i
• • ;.i; ;i2ii1i • "', '" "'" "" 0 1,050
~ ::::: ::~-~I- BciidS·u.s.
I999.ToiaI - , t Bonds "009.'" 0 1,050 to"" Tn'"1 I he, I Bond, 0 0 0 ~ Tn'al - ;'a'e. ·e,ritnrie. and " Bnnds 0 0 0
0 0 0 0 0 0
~ Total - 'olitical i . i ; Bonds ~-u:s: Soecial ; Bonds I 3899999. Tot.f:lndustiial and II I I Bonds 0 0 0
0 0 0
0 0 0
0 0 0
~~:::~~:;:'~~,a~ndIA~Hiliia~les'B~ond~s ________________________________________________________________________ +-__________ ~------------~----------~ ~ Subtotal-SV~nds ~-TsSu9r 7899999. Total - i
~ ~:::: - Other Loan~BaCked and ~ Total - SVO Identified Funds ~
I Securities I Securities
. IFtOERATED INVESTcmlNC T1a9Jli OOLIGATlct< f\Nl . 1 RoOOO"" ";"hl ,,", . FYemnl Mnnev Market Mutual Funds - as Identified bv the SVO I .. · ...... ···
I 8899999 -Tot,fCash i
.DIlIlIl
.. "" '" 0 ., 0 0
.. """" 682
1.100,080
0
0 0 0 0
0
2
2
1.050 0 0 0 0
1.050
9
................
... ......
1.059
III III1I1IIIII Goa I
SUPPLEMENT FOR THE QUARTER ENDING SEPTEMBER 30, 2018 OF THE Aetna Better Health of Iowa Inc.
MEDICARE PART D COVERAGE SUPPLEMENT NAIC Code 0001
1. Premiums Collected .
2. Earned Premiums __
3. Claims Paid ........................................................... .
4. Claims Incurred ............................................. .
5. Reinsurance Coverage and Low Income Cost Sharing - Claims Paid Net of Reimbursements Applied <aJ .... .................................. ......... . ..... .
6. Aggregate Policy Reserves - Change .... ..... . .. ~
7. Expenses Paid ............................................................. .
8. Expenses Incurred ....................................... . .......... .
(Net of Reinsurance) Code 15805
Total Cash
9. Underwriting Gain or Loss ................................. . f································· j... ... .~N' ........... f ................................... +.. ...... AI\A........+ .............. AAA ............ 1
<aJ Uninsured Receivable/Payable with CMS at End of Quarter: $ ..................................... due from CMS or $ ....................................... due to CMS
365
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