SFY 2018 - 2019 MC MLR Report Summary
Medicaid line of business
- Report also available in Portable Document Format (PDF)
| SFY 2018 - 2019 MC MLR Report Summary | |||||||
|---|---|---|---|---|---|---|---|
| Medicaid line of business | |||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium (Total Denominator) |
Remittance | Credible | MMs | |
| Affinity Health Plan, Inc. | 95.65% | $1,050,305,504 | $1,098,031,872 | $0 | Fully Credible | 2,469,641 | |
| Capital District Physicians Health Plan, Inc (CDPHP) | 88.09% | $400,006,089 | $454,070,427 | $0 | Fully Credible | 965,972 | |
| Crystal Run Health Plan, LLC | 104.29% | $7,538,600 | $7,583,953 | $0 | Partially Credible | 17,695 | |
| Excellus Health Plan, Inc | 91.73% | $814,865,052 | $888,324,008 | $0 | Fully Credible | 2,017,610 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 90.03% | $6,031,635,922 | $6,699,516,873 | $0 | Fully Credible | 14,679,496 | |
| Health Insurance Plan of Greater New York (Emblem) | 94.60% | $767,640,126 | $811,491,216 | $0 | Fully Credible | 1,562,997 | |
| Healthfirst PHSP, Inc. | 94.43% | $5,113,905,022 | $5,415,637,973 | $0 | Fully Credible | 11,138,290 | |
| Highmark Western and Northeastern New York Inc. (frmly Healthnow) | 93.20% | $204,813,119 | $219,758,220 | $0 | Fully Credible | 390,800 | |
| HealthPlus HP, LLC | 93.24% | $1,538,349,970 | $1,649,977,538 | $0 | Fully Credible | 3,915,257 | |
| Independent Health Association, Inc | 94.20% | $297,882,310 | $316,228,287 | $0 | Fully Credible | 666,834 | |
| MVP Health Plan, Inc. | 92.36% | $877,464,243 | $950,079,000 | $0 | Fully Credible | 1,954,987 | |
| MetroPlus Health Plan, Inc | 91.52% | $1,682,982,905 | $1,838,949,478 | $0 | Fully Credible | 4,417,560 | |
| Molina Healthcare of New York, Inc. | 86.67% | $128,255,037 | $149,918,810 | $0 | Partially Credible | 335,771 | |
| United Healthcare of New York, Inc. | 90.34% | $2,128,246,854 | $2,355,761,274 | $0 | Fully Credible | 5,623,133 | |
| WellCare of New York, Inc. | 87.33% | $436,078,808 | $499,362,787 | $0 | Fully Credible | 1,245,273 | |
| YourCare Health Plan, Inc. | 94.40% | $201,955,069 | $213,934,843 | $0 | Fully Credible | 454,941 | |
| Total | $21,681,924,631 | $23,568,626,559 | $0 | 51,856,257 | |||
NOTES:
Please note that the Remittance is for this line of business for one year ONLY based on a MLR Target of 86%.
No remittance for plan if Non-Credible
