SFY 2019 - 2020 MC MLR Report Summary
PACE line of business (Informational Only)
- Report also available in Portable Document Format (PDF)
| SFY 2019 - 2020 MC MLR Report Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| PACE line of business (Informational Only) | ||||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium USED FOR MLR% (Total Denominator) |
Medicaid Only Premium USED FOR REMITTANCE | Remittance | Credible | MMs | |
| Catholic Managed Long Term Care, Inc. | 95.87% | $88,711,188 | $99,409,976 | $62,835,823 | $0 | Partially Credible | 9,717 | |
| Catholic Health System PACE (Catholic Health - Life Pace (CHS Buffalo)) | 89.54% | $22,045,371 | $24,621,543 | $13,674,977 | $0 | Non-Credible | 3,228 | |
| Centerlight Healthcare Inc. | 108.41% | $326,425,043 | $311,520,555 | $213,385,731 | $0 | Partially Credible | 32,014 | |
| Complete Senior Care, Inc. | 82.39% | $9,233,697 | $11,207,470 | $6,236,714 | $0 | Non-Credible | 1,598 | |
| Fallon Health Weinberg, Inc. (frmly TAIPP) | 84.88% | $10,032,010 | $11,818,578 | $7,210,767 | $0 | Non-Credible | 1,699 | |
| Independent Living for Seniors (d/b/a ElderOne or ILS) | 102.54% | $69,298,264 | $72,479,501 | $38,913,802 | $0 | Partially Credible | 8,998 | |
| Loretto Independent Living Services, Inc. (d/b/a PACE CNY) | 104.18% | $57,738,626 | $59,695,743 | $31,924,052 | $0 | Partially Credible | 7,690 | |
| Senior Care Connection, Inc. (d/b/a Eddy Senior Care) | 98.90% | $21,758,147 | $22,000,346 | $11,588,639 | $0 | Non-Credible | 2,719 | |
| Total Senior Care, Inc. | 93.14% | $10,227,899 | $10,981,055 | $6,452,516 | $0 | Non-Credible | 1,541 | |
| Total | $615,470,245 | $623,734,767 | $392,223,021 | $0 | Total | 69,204 | ||
NOTES:
Please note the MLR Target is 86% for this line of business.
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 PACE line of business (informational ONLY)
