SFY 2017 - 2018 MC MLR Report Summary
MAP line of business
- Report also available in Portable Document Format (PDF)
| SFY 2017 - 2018 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 | |
| Elderplan, Inc. d/b/a Homefirst | 83.47% | $86,285,037 | $110,367,064 | $77,465,860 | $1,959,886 | Partially Credible | 14,868 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 105.28% | $8,963,697 | $8,514,366 | $5,413,242 | $0 | Non-Credible | 1,272 | |
| GuildNet, Inc. | 93.59% | $42,399,832 | $48,071,700 | $36,795,531 | $0 | Partially Credible | 14,217 | |
| Healthfirst Healthplan, Inc. | 92.94% | $380,263,360 | $421,365,462 | $288,727,778 | $0 | Partially Credible | 59,323 | |
| HealthPlus HP, LLC | 93.55% | $87,168 | $93,183 | $93,183 | $0 | Non-Credible | 24 | |
| Senior Whole Health of New York, Inc. | 97.98% | $9,528,910 | $9,725,620 | $7,218,705 | $0 | Non-Credible | 1,287 | |
| Village Senior Services Corp. (VillageCare Max) | 95.23% | $7,226,738 | $7,588,427 | $5,439,345 | $0 | Non-Credible | 1,128 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 80.63% | $90,032,045 | $118,948,574 | $84,913,387 | $4,559,849 | Partially Credible | 17,363 | |
| Total | $624,786,787 | $724,674,395 | $506,070,208 | $6,519,735 | 109,482 | |||
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
Updated 11/6/2023
