SFY 2019 - 2020 MC MLR Report Summary
MAP line of business
- Report also available in Portable Document Format (PDF)
| SFY 2019 - 2020 MC MLR Report Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| MAP line of business | ||||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium USED FOR MLR% (Total Denominator) |
Medicaid Only Premium USED FOR REMITTANCE |
Remittance | Credible | MMs | |
| Centers Plan for Healthy Living, LLC | 161.51% | $1,897,053 | $1,174,606 | $860,889 | $0 | Non-Credible | 158 | |
| Elderplan, Inc. d/b/a Homefirst | 87.80% | $120,183,441 | $144,624,410 | $102,531,760 | $0 | Partially Credible | 19,058 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 92.52% | $6,478,503 | $7,001,977 | $4,662,702 | $0 | Non-Credible | 926 | |
| Healthfirst Healthplan, Inc. | 93.42% | $902,205,638 | $984,374,207 | $686,134,657 | $0 | Credible | 140,073 | |
| HealthPlus HP, LLC | 84.46% | $514,991 | $609,741 | $609,741 | $0 | Non-Credible | 125 | |
| Senior Whole Health of New York, Inc. | 103.77% | $10,744,282 | $10,353,869 | $7,286,103 | $0 | Non-Credible | 1,263 | |
| Village Senior Services Corp. (VillageCare Max) | 92.53% | $125,079,714 | $142,430,718 | $103,144,307 | $0 | Partially Credible | 19,013 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 86.56% | $207,180,748 | $249,974,150 | $182,430,600 | $0 | Partially Credible | 30,999 | |
| Total | $1,374,284,369 | $1,540,543,678 | $1,087,660,760 | $0 | 211,615 | |||
NOTES:
Please note that the Remittance is for this line of business for one year ONLY based on a MLR Target of 86%.
The MLR% calculation for the Medicaid/Medicare integrated lines of business includes both the Medicare and Medicaid experience.
Remittances, if applicable, are calculated by multiplying the MLR% by the Medicaid Only Premium.
No remittance for plan if Non-Credible
Agewell NY MAP LOB initial start date 10/1/2019.
