SFY 2017 - 2018 MC MLR Report Summary

Medicaid line of business

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SFY 2017 - 2018 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. 94.69% $1,091,272,723 $1,152,530,013 $0 Fully Credible 2,631,643
Capital District Physicians Health Plan, Inc (CDPHP) 94.58% $406,472,230 $429,749,972 $0 Fully Credible 984,308
Crystal Run Health Plan, LLC 93.89% $6,156,974 $6,949,934 $0 Partially Credible 14,797
Excellus Health Plan, Inc 95.25% $812,942,866 $853,531,673 $0 Fully Credible 1,989,694
New York State Catholic Health Plan, Inc. (Fidelis Legacy) 91.20% $5,736,812,562 $6,290,284,200 $0 Fully Credible 14,372,751
Health Insurance Plan of Greater New York (Emblem) 100.23% $835,733,897 $833,861,296 $0 Fully Credible 1,755,262
Healthfirst PHSP, Inc. 94.46% $5,029,807,140 $5,324,595,784 $0 Fully Credible 10,970,370
Highmark Western and Northeastern New York Inc. (frmly Healthnow) 98.98% $176,084,293 $179,956,083 $0 Partially Credible 330,191
HealthPlus HP, LLC 93.92% $1,611,090,221 $1,715,377,892 $0 Fully Credible 4,168,827
Independent Health Association, Inc 101.30% $315,129,875 $311,102,500 $0 Fully Credible 711,492
MVP Health Plan, Inc. 96.91% $882,498,812 $910,655,281 $0 Fully Credible 1,938,290
MetroPlus Health Plan, Inc 92.37% $1,702,787,774 $1,843,479,057 $0 Fully Credible 4,491,141
Molina Healthcare of New York, Inc. 93.01% $140,061,047 $152,307,668 $0 Partially Credible 362,899
United Healthcare of New York, Inc. 90.78% $2,023,517,831 $2,228,996,895 $0 Fully Credible 5,601,506
WellCare of New York, Inc. 85.35% $400,762,532 $469,566,107 $3,052,180 Fully Credible 1,197,426
YourCare Health Plan, Inc. 94.05% $220,196,017 $234,116,779 $0 Fully Credible 502,137
Total   $21,391,326,794 $22,937,061,134 $3,052,180   52,022,734

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