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{"sheet":"Part_1_Mini Med","index":0,"n_rows":60,"n_cols":17,"rows_kept":60,"cut":false,"hidden":false,"merged":[[0,1,0,8],[1,1,1,8],[2,1,2,8],[19,5,19,8],[58,1,58,8]],"flags":["formulas_cached_only"]}
[null,"Department of Health and Human Services, Centers for Medicare and Medicaid Services",{"$nulls":12},"Quarter","Year","State Abbreviation"]
[null,"Medical Loss Ratio Quarterly Reporting Form - \"Mini-Med\" Plans"]
[null,"Part 1",{"$nulls":12},1,2011,"AK"]
[null,null,null,"Report for: -  Corporation - (Fill in below)",{"$nulls":10},2,null,"AL"]
[{"$nulls":5},"NAIC Group Code:",{"$nulls":8},3,null,"AR"]
[{"$nulls":16},"AS"]
[null,null,null,"Location: - (Select from the drop-down menu below)",null,"Business in the State of: ",{"$nulls":10},"AZ"]
[{"$nulls":16},"CA"]
[{"$nulls":5},"NAIC Company Code:",{"$nulls":10},"CN"]
[null,null,null,"Corporation Contact Information",{"$nulls":12},"CO"]
[null,null,null,"Please provide contact information for the issuer regarding this filing",null,"Quarter:",{"$nulls":10},"CT"]
[null,null,null,"    Name:",{"$nulls":12},"DC"]
[{"$nulls":5},"Year:",{"$nulls":10},"DE"]
[null,null,null,"    Telephone:",{"$nulls":12},"FL"]
[{"$nulls":16},"GA"]
[null,null,null,"    Email:",{"$nulls":12},"GU"]
[{"$nulls":16},"HI"]
[null,null,null,"    Mailing Address:",{"$nulls":12},"IA"]
[{"$nulls":16},"ID"]
[{"$nulls":5},"\"Mini-Med\"",{"$nulls":10},"IL"]
[{"$nulls":4},"NAIC SHCE Cross Reference","1\nIndividual","2\nSmall Group \nEmployer","3\nLarge Group Employer","4\nTotal Mini-Med\n1 + 2 + 3",{"$nulls":7},"IN"]
[null,"1.","Adjusted premium:",{"$nulls":13},"KS"]
[null,null,1.1,"  Direct premium earned",null,0,0,0,0,{"$nulls":7},"KY"]
[null,null,1.2,"  Federal high risk pools","Pt 1, Ln 1.2",null,null,null,0,{"$nulls":7},"LA"]
[null,null,1.3,"  State high risk pools","Pt 1, Ln 1.3",null,null,null,0,{"$nulls":7},"MA"]
[null,null,1.4,"  Federal taxes and federal assessments","Pt 1, Ln 1.5",null,null,null,0,{"$nulls":7},"MD"]
[null,null,1.5,"  State insurance, premium and other taxes","Pt 1, Ln 1.6",null,null,null,0,{"$nulls":7},"ME"]
[null,null,1.6,"  Regulatory authority licenses and fees","Pt 1, Ln 1.7",null,null,null,0,{"$nulls":7},"MI"]
[null,null,1.7,"  Adjusted premium (Lines 1.1 + 1.2 + 1.3 – 1.4 – 1.5 – 1.6)",null,0,0,0,0,{"$nulls":7},"MN"]
[null,"2.","Claims",{"$nulls":13},"MO"]
[null,null,2.1,"  Incurred claims excluding presecription drugs","Pt 1, Ln 2.1",null,null,null,0,{"$nulls":7},"MP"]
[null,null,2.2,"  Prescription drugs","Pt 1, Ln 2.2",null,null,null,0,{"$nulls":7},"MS"]
[null,null,2.3,"  Pharmaceutical rebates","Pt 1, Ln 2.3",null,null,null,0,{"$nulls":7},"MT"]
[null,null,2.4,"  State stop loss, market stabilization and claim/census based assessments","Pt 1, Ln 2.4",null,null,null,0,{"$nulls":7},"NC"]
[null,"3.","Incurred medical incentive pools and bonues",null,"Pt 1, Ln 3",0,0,0,0,{"$nulls":7},"ND"]
[null,"4.","Deductible Fraud and Abuse Recoveries.",null,"Pt 1, Ln 4",0,0,0,0,{"$nulls":7},"NE"]
[null,"5.","Total Incurred Claims (Lines 2.1 + 2.2 – 2.3 – 2.4 + 3) (Should equal Part 2, Line 2.16)",null,null,0,0,0,0,{"$nulls":7},"NH"]
[null,"6.","Improving Health Care Quality Expenses Incurred:",{"$nulls":13},"NJ"]
[null,null,6.1,"  Type A. Expenses for health improvements other than Health Information Technology","Pt 1, Ln 6.1",null,null,null,0,{"$nulls":7},"NM"]
[null,null,6.2,"  Type B. Health Information Technology expenses related to health improvement","Pt 1, Ln 6.2",null,null,null,0,{"$nulls":7},"NV"]
[null,null,6.3,"  Total of defined expenses incurred for improving health care quality (Lines 6.1 + 6.2)","Pt 1, Ln 6.3",0,0,0,0,{"$nulls":7},"NY"]
[null,"7.","Preliminary MLR (Lines 4 + 5 + 6.3 divided by Line 1.7)",null,null,{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},"XXX",{"$nulls":7},"OH"]
[null,"8.","Non-Claims Costs:",{"$nulls":13},"OK"]
[null,null,8.1,"  Cost Containment expenses not included in quality of care expenses in Line 6.3","Pt 1, Ln 8.1",null,null,null,0,{"$nulls":7},"OR"]
[null,null,8.2,"  All other claims adjustment expenses","Pt 1, Ln 8.2",null,null,null,0,{"$nulls":7},"OT"]
[null,null,8.3,"  Direct sales salaries and benefits","Pt 1, Ln 10.1",null,null,null,0,{"$nulls":7},"PA"]
[null,null,8.4,"  Agents and brokers fees and commissions","Pt 1, Ln 10.2",null,null,null,0,{"$nulls":7},"PR"]
[null,null,8.5,"  Other taxes","Pt 1, Ln 10.3",null,null,null,0,{"$nulls":7},"RI"]
[null,null,8.6,"  Other general and administrative expenses","Pt 1, Ln 10.4",null,null,null,0,{"$nulls":7},"SC"]
[null,null,8.7,"  Total non-claims expense (Lines 8.1 + 8.2 + 8.3 + 8.4 + 8.5 + 8.6)",null,0,0,0,0,{"$nulls":7},"SD"]
[null,null,8.8,"  ICD-10 Implementation expenses (informational only)","Pt 1, Ln 16",null,null,null,0,{"$nulls":7},"TN"]
[null,"9.","Underwriting gain/(loss) (Lines 1.7 – 5 – 6.3 – 8.7)",null,"Pt 1, Ln 11",0,0,0,0,{"$nulls":7},"TX"]
[null,null,"Other Indicators:",{"$nulls":13},"UT"]
[null,"1.","Number of certificates/policies",null,"Pt 1 Other, Ln 1",null,null,null,0,{"$nulls":7},"VA"]
[null,"2.","Number of covered lives",null,"Pt 1 Other, Ln 2",null,null,null,0,{"$nulls":7},"VI"]
[null,"3.","Number of groups",null,"Pt 1 Other, Ln 3","XX",null,null,0,{"$nulls":7},"VT"]
[null,"4.","Member Months",null,"Pt 1 Other, Ln 4",null,null,null,0,{"$nulls":7},"WA"]
[{"$nulls":16},"WI"]
[null,"See instructions provided in accompanying document.",{"$nulls":14},"WV"]
[{"$nulls":16},"WY"]

{"sheet":"Part_2_Mini Med","index":1,"n_rows":43,"n_cols":9,"rows_kept":43,"cut":false,"hidden":false,"merged":[[0,1,0,8],[1,1,1,8],[2,1,2,8],[5,5,5,8],[42,1,42,8]],"flags":["formulas_cached_only"]}
[null,"Department of Health and Human Services, Centers for Medicare and Medicaid Services"]
[null,"Medical Loss Ratio Quarterly Reporting Form - \"Mini-Med\" Plans"]
[null,"Part 2"]
[]
[]
[{"$nulls":5},"\"Mini-Med\""]
[{"$nulls":4},"NAIC SHCE Cross Reference","1\nIndividual","2\nSmall Group \nEmployer","3\nLarge Group Employer","4\nTotal Mini-Med\n1 + 2 + 3"]
[null,"1.","Premium"]
[null,null,1.1,"  Direct premium written","Pt 2, Ln 1.1",null,null,null,0]
[null,null,1.2,"  Unearned premium, as of end of prior year","Pt 2, Ln 1.2",null,null,null,0]
[null,null,1.3,"  Unearned premium, as of end of current quarter","Pt 2, Ln 1.3",null,null,null,0]
[null,null,1.4,"  Premium write-offs","incl. in Pt 2, Ln 1.8",null,null,null,0]
[null,null,1.5,"  Group conversion charges","incl. in Supp Form, Ln 2",null,null,null,0]
[null,null,1.6,"  Adjusted direct premiums earned (Lines 1.1 + 1.2 – 1.3 – 1.4 + 1.5)",null,0,0,0,0]
[]
[null,"2.","Claims"]
[null,null,2.1,"  Paid claims","Pt 2, Ln 2.1",null,null,null,0]
[null,null,2.2,"  Direct claim liability, as of end of current quarter","Pt 2, Ln 2.2",null,null,null,0]
[null,null,2.3,"  Direct claim liability, as of end of prior year","Pt 2, Ln 2.3",null,null,null,0]
[null,null,2.4,"  Direct claim reserves, as of end of current quarter","Pt 2, Ln 2.4",null,null,null,0]
[null,null,2.5,"  Direct claim reserves, as of end of prior year","Pt.2, Ln 2.5",null,null,null,0]
[null,null,2.6,"  Direct contract reserves, as of end of current quarter","Pt 2, Ln 2.6",null,null,null,0]
[null,null,2.7,"  Direct contract reserves, as of end of prior year","Pt.2, Ln 2.7",null,null,null,0]
[null,null,2.8,"  Paid rate credits","Supp Form, Ln 7",null,null,null,0]
[null,null,2.9,"  Reserve for rate credits, as of end of current quarter","Supp Form, Ln 7",null,null,null,0]
[null,null,2.1,"  Reserve for rate credits, as of end of prior year","Supp Form, Ln 7",null,null,null,0]
[null,null,2.11,"  Incurred medical incentive pools and bonuses (Lines 2.11a + 2.11b – 2.11c)","Pt 2, Ln 2.8",0,0,0,0]
[null,null,null,"2.11a. Paid medical incentive pools and bonuses as of end of current quarter","Pt 2, Ln 2.8a",null,null,null,0]
[null,null,null,"2.11b. Accrued medical incentive pools and bonuses, as of end of current quarter","Pt 2, Ln 2.8b",null,null,null,0]
[null,null,null,"2.11c. Accrued medical incentive pools and bonuses, as of end of prior year","Pt 2, Ln 2.8c",null,null,null,0]
[null,null,2.12,"  Healthcare receivables (Lines 2.12a – 2.12b)","Pt 2, Ln 2.9",0,0,0,0]
[null,null,null,"2.12a.  Healthcare receivables, as of end of current quarter","Pt 2, Ln 2.9a",null,null,null,0]
[null,null,null,"2.12b.  Healthcare receivables, as of end of prior year","Pt 2, Ln 2.9b",null,null,null,0]
[null,null,2.13,"  Contingent Benefit and Lawsuit reserves, as of end of current quarter","Supp Form, Ln 9",null,null,null,0]
[null,null,2.14,"  Group conversion charges","incl. in Supp Form, Ln 5",null,null,null,0]
[null,null,2.15,"  Multi-option coverage blended rate adjustment","incl. in Supp Form, Ln 5",null,null,null,0]
[null,null,2.16,"  Total incurred claims (Lines 2.1 + 2.2 – 2.3 + 2.4 – 2.5 + 2.6 – 2.7 + 2.8 + 2.9 – 2.10 + 2.11\n   – 2.12 + 2.13 + 2.14 + 2.15)",null,0,0,0,0]
[null,"3.","Deductible Fraud and Abuse recovery expense"]
[null,null,3.1,"  Total Fraud and Abuse recoveries expense (informational only)","Pt 3, Col 7, Ln x.11",null,null,null,0]
[null,null,3.2,"  Total Fraud and Abuse recoveries of paid claims (informational only)",{"$nulls":4},0]
[null,null,3.3,"  Deductible Fraud and Abuse recovery expense (the lesser of Line 3.1 or 3.2)","Pt 1, Ln 4",0,0,0,0]
[]
[null,"See instructions provided in accompanying document."]

{"sheet":"Part_1_Expat","index":2,"n_rows":60,"n_cols":17,"rows_kept":60,"cut":false,"hidden":false,"merged":[[0,1,0,7],[1,1,1,7],[2,1,2,7],[19,5,19,7],[58,1,58,7]],"flags":["formulas_cached_only"]}
[null,"Department of Health and Human Services, Centers for Medicare and Medicaid Services",{"$nulls":12},"Quarter","Year","State abbreviation"]
[null,"Medical Loss Ratio Quarterly Reporting Form - Expatriate Plans"]
[null,"Part 1",{"$nulls":12},1,2011,"AK"]
[null,null,null,"Report for: -  Corporation - (Fill in below)",{"$nulls":10},2,null,"AL"]
[{"$nulls":5},"NAIC Group Code:",{"$nulls":8},3,null,"AR"]
[{"$nulls":16},"AS"]
[null,null,null,"Location: - (Select from the drop-down menu below)",null,"Business in the State of: (List All)",{"$nulls":10},"AZ"]
[{"$nulls":16},"CA"]
[{"$nulls":5},"NAIC Company Code:",{"$nulls":10},"CN"]
[null,null,null,"Corporation Contact Information",{"$nulls":12},"CO"]
[null,null,null,"Please provide contact information for the issuer regarding this filing",null,"Quarter:",{"$nulls":10},"CT"]
[null,null,null,"    Name:",{"$nulls":12},"DC"]
[{"$nulls":5},"Year:",{"$nulls":10},"DE"]
[null,null,null,"    Telephone:",{"$nulls":12},"FL"]
[{"$nulls":16},"GA"]
[null,null,null,"    Email:",{"$nulls":12},"GU"]
[{"$nulls":16},"HI"]
[null,null,null,"    Mailing Address:",{"$nulls":12},"IA"]
[{"$nulls":16},"ID"]
[{"$nulls":5},"Expatriate",{"$nulls":10},"IL"]
[{"$nulls":4},"NAIC SHCE Cross Reference","1\nSmall Group\nNational Aggregation","2\nLarge Group\nNational Aggregation","3\nTotal Expatriate\n1 + 2",{"$nulls":8},"IN"]
[null,"1.","Adjusted premium:",{"$nulls":13},"KS"]
[null,null,1.1,"  Direct premium earned",null,0,0,0,{"$nulls":8},"KY"]
[null,null,1.2,"  Federal high risk pools","Pt 1, Ln 1.2",null,null,0,{"$nulls":8},"LA"]
[null,null,1.3,"  State high risk pools","Pt 1, Ln 1.3",null,null,0,{"$nulls":8},"MA"]
[null,null,1.4,"  Federal taxes and federal assessments","Pt 1, Ln 1.5",null,null,0,{"$nulls":8},"MD"]
[null,null,1.5,"  State insurance, premium and other taxes","Pt 1, Ln 1.6",null,null,0,{"$nulls":8},"ME"]
[null,null,1.6,"  Regulatory authority licenses and fees","Pt 1, Ln 1.7",null,null,0,{"$nulls":8},"MI"]
[null,null,1.7,"  Adjusted premium (Lines 1.1 + 1.2 + 1.3 – 1.4 – 1.5 – 1.6)",null,0,0,0,{"$nulls":8},"MN"]
[null,"2.","Claims",{"$nulls":13},"MO"]
[null,null,2.1,"  Incurred claims excluding presecription drugs","Pt 1, Ln 2.1",null,null,0,{"$nulls":8},"MP"]
[null,null,2.2,"  Prescription drugs","Pt 1, Ln 2.2",null,null,0,{"$nulls":8},"MS"]
[null,null,2.3,"  Pharmaceutical rebates","Pt 1, Ln 2.3",null,null,0,{"$nulls":8},"MT"]
[null,null,2.4,"  State stop loss, market stabilization and claim/census based assessments","Pt 1, Ln 2.4",null,null,0,{"$nulls":8},"NC"]
[null,"3.","Incurred medical incentive pools and bonues",null,"Pt 1, Ln 3",0,0,0,{"$nulls":8},"ND"]
[null,"4.","Deductible Fraud and Abuse Recoveries.",null,"Pt 1, Ln 4",0,0,0,{"$nulls":8},"NE"]
[null,"5.","Total Incurred Claims (Lines 2.1 + 2.2 – 2.3 – 2.4 + 3) (Should equal Part 2, Line 2.16)",null,null,0,0,0,{"$nulls":8},"NH"]
[null,"6.","Improving Health Care Quality Expenses Incurred:",{"$nulls":13},"NJ"]
[null,null,6.1,"  Type A. Expenses for health improvements other than Health Information Technology","Pt 1, Ln 6.1",null,null,0,{"$nulls":8},"NM"]
[null,null,6.2,"  Type B. Health Information Technology expenses related to health improvement","Pt 1, Ln 6.2",null,null,0,{"$nulls":8},"NV"]
[null,null,6.3,"  Total of defined expenses incurred for improving health care quality (Lines 6.1 + 6.2)","Pt 1, Ln 6.3",0,0,0,{"$nulls":8},"NY"]
[null,"7.","Preliminary MLR (Lines 4 + 5 + 6.3 divided by Line 1.7)",null,null,{"$error":"#DIV/0!"},{"$error":"#DIV/0!"},"XXX",{"$nulls":8},"OH"]
[null,"8.","Non-Claims Costs:",{"$nulls":13},"OK"]
[null,null,8.1,"  Cost Containment expenses not included in quality of care expenses in Line 6.3","Pt 1, Ln 8.1",null,null,0,{"$nulls":8},"OR"]
[null,null,8.2,"  All other claims adjustment expenses","Pt 1, Ln 8.2",null,null,0,{"$nulls":8},"OT"]
[null,null,8.3,"  Direct sales salaries and benefits","Pt 1, Ln 10.1",null,null,0,{"$nulls":8},"PA"]
[null,null,8.4,"  Agents and brokers fees and commissions","Pt 1, Ln 10.2",null,null,0,{"$nulls":8},"PR"]
[null,null,8.5,"  Other taxes","Pt 1, Ln 10.3",null,null,0,{"$nulls":8},"RI"]
[null,null,8.6,"  Other general and administrative expenses","Pt 1, Ln 10.4",null,null,0,{"$nulls":8},"SC"]
[null,null,8.7,"  Total non-claims expense (Lines 8.1 + 8.2 + 8.3 + 8.4 + 8.5 + 8.6)",null,0,0,0,{"$nulls":8},"SD"]
[null,null,8.8,"  ICD-10 Implementation expenses (informational only)","Pt 1, Ln 16",null,null,0,{"$nulls":8},"TN"]
[null,"9.","Underwriting gain/(loss) (Lines 1.7 – 5 – 6.3 – 8.7)",null,"Pt 1, Ln 11",0,0,0,{"$nulls":8},"TX"]
[null,null,"Other Indicators:",{"$nulls":13},"UT"]
[null,"1.","Number of certificates/policies",null,"Pt 1 Other, Ln 1",null,null,0,{"$nulls":8},"VA"]
[null,"2.","Number of covered lives",null,"Pt 1 Other, Ln 2",null,null,0,{"$nulls":8},"VI"]
[null,"3.","Number of groups",null,"Pt 1 Other, Ln 3",null,null,0,{"$nulls":8},"VT"]
[null,"4.","Member Months",null,"Pt 1 Other, Ln 4",null,null,0,{"$nulls":8},"WA"]
[{"$nulls":16},"WI"]
[null,"See instructions provided in accompanying document.",{"$nulls":14},"WV"]
[{"$nulls":16},"WY"]

{"sheet":"Part_2_Expat","index":3,"n_rows":43,"n_cols":8,"rows_kept":43,"cut":false,"hidden":false,"merged":[[0,1,0,7],[1,1,1,7],[2,1,2,7],[5,5,5,7],[42,1,42,7]],"flags":["formulas_cached_only"]}
[null,"Department of Health and Human Services, Centers for Medicare and Medicaid Services"]
[null,"Medical Loss Ratio Quarterly Reporting Form - Expatriate Plans"]
[null,"Part 2"]
[]
[]
[{"$nulls":5},"Expatriate"]
[{"$nulls":4},"NAIC SHCE Cross Reference","1\nSmall Group\nNational Aggregation","2\nLarge Group\nNational Aggregation","3\nTotal Expatriate\n1 + 2"]
[null,"1.","Premium"]
[null,null,1.1,"  Direct premium written","Pt 2, Ln 1.1",null,null,0]
[null,null,1.2,"  Unearned premium, as of end of prior year","Pt 2, Ln 1.2",null,null,0]
[null,null,1.3,"  Unearned premium, as of end of current quarter","Pt 2, Ln 1.3",null,null,0]
[null,null,1.4,"  Premium write-offs","incl. in Pt 2, Ln 1.8",null,null,0]
[null,null,1.5,"  Group conversion charges","incl. in Supp Form, Ln 2",null,null,0]
[null,null,1.6,"  Adjusted direct premiums earned (Lines 1.1 + 1.2 – 1.3 – 1.4 + 1.5)",null,0,0,0]
[]
[null,"2.","Claims"]
[null,null,2.1,"  Paid claims","Pt 2, Ln 2.1",null,null,0]
[null,null,2.2,"  Direct claim liability, as of end of current quarter","Pt 2, Ln 2.2",null,null,0]
[null,null,2.3,"  Direct claim liability, as of end of prior year","Pt 2, Ln 2.3",null,null,0]
[null,null,2.4,"  Direct claim reserves, as of end of current quarter","Pt 2, Ln 2.4",null,null,0]
[null,null,2.5,"  Direct claim reserves, as of end of prior year","Pt.2, Ln 2.5",null,null,0]
[null,null,2.6,"  Direct contract reserves, as of end of current quarter","Pt 2, Ln 2.6",null,null,0]
[null,null,2.7,"  Direct contract reserves, as of end of prior year","Pt.2, Ln 2.7",null,null,0]
[null,null,2.8,"  Paid rate credits","Supp Form, Ln 7",null,null,0]
[null,null,2.9,"  Reserve for rate credits, as of end of current quarter","Supp Form, Ln 7",null,null,0]
[null,null,2.1,"  Reserve for rate credits, as of end of prior year","Supp Form, Ln 7",null,null,0]
[null,null,2.11,"  Incurred medical incentive pools and bonuses (Lines 2.11a + 2.11b – 2.11c)","Pt 2, Ln 2.8",0,0,0]
[null,null,null,"2.11a. Paid medical incentive pools and bonuses as of end of current quarter","Pt 2, Ln 2.8a",null,null,0]
[null,null,null,"2.11b. Accrued medical incentive pools and bonuses, as of end of current quarter","Pt 2, Ln 2.8b",null,null,0]
[null,null,null,"2.11c. Accrued medical incentive pools and bonuses, as of end of prior year","Pt 2, Ln 2.8c",null,null,0]
[null,null,2.12,"  Healthcare receivables (Lines 2.12a – 2.12b)","Pt 2, Ln 2.9",0,0,0]
[null,null,null,"2.12a.  Healthcare receivables, as of end of current quarter","Pt 2, Ln 2.9a",null,null,0]
[null,null,null,"2.12b.  Healthcare receivables, as of end of prior year","Pt 2, Ln 2.9b",null,null,0]
[null,null,2.13,"  Contingent Benefit and Lawsuit reserves, as of end of current quarter","Supp Form, Ln 9",null,null,0]
[null,null,2.14,"  Group conversion charges","incl. in Supp Form, Ln 5",null,null,0]
[null,null,2.15,"  Multi-option coverage blended rate adjustment","incl. in Supp Form, Ln 5",null,null,0]
[null,null,2.16,"  Total incurred claims (Lines 2.1 + 2.2 – 2.3 + 2.4 – 2.5 + 2.6 – 2.7 + 2.8 + 2.9 – 2.10 + 2.11\n   – 2.12 + 2.13 + 2.14 + 2.15)",null,0,0,0]
[null,"3.","Deductible Fraud and Abuse recovery expense"]
[null,null,3.1,"  Total Fraud and Abuse recoveries expense (informational only)","Pt 3, Col 7, Ln x.11",null,null,0]
[null,null,3.2,"  Total Fraud and Abuse recoveries of paid claims (informational only)",null,null,null,0]
[null,null,3.3,"  Deductible Fraud and Abuse recovery expense (the lesser of Line 3.1 or 3.2)","Pt 1, Ln 4",0,0,0]
[]
[null,"See instructions provided in accompanying document."]