SFY 2017 - 2018 MC MLR Report Summary
Medicaid Advantage (MA) line of business
- Report also available in Portable Document Format (PDF)
| SFY 2017 - 2018 MC MLR Report Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| Medicaid Advantage (MA) 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 | |
| Affinity Health Plan, Inc. | 74.67% | $2,441,278 | $3,269,357 | $3,269,357 | $0 | Non-Credible | 2,287 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 102.26% | $24,929,276 | $25,593,375 | $25,593,375 | $0 | Partially Credible | 17,997 | |
| United Healthcare of New York, Inc. | 144.72% | $73,374,109 | $51,883,767 | $51,883,767 | $0 | Partially Credible | 39,231 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 92.41% | $7,022,517 | $8,254,583 | $8,254,583 | $0 | Partially Credible | 8,001 | |
| WellCare of New York, Inc. | 95.21% | $28,783,223 | $31,511,892 | $31,511,892 | $0 | Partially Credible | 26,917 | |
| Total | $136,550,403 | $120,512,974 | $120,512,974 | $0 | 94,433 | |||
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
Please note that Medicaid Advantage line of business has a Calendar Year (CY) 1/1-12/31 rating period.
