SFY 2018 - 2019 MC MLR Report Summary
FIDA line of business
- Report also available in Portable Document Format (PDF)
| SFY 2018 - 2019 MC MLR Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| FIDA 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 | |
| AgeWell New York, LLC | 99.95% | $17,519,699 | $17,527,882 | $12,806,345 | $0 | Non-Credible | 2,036 | |
| Centers Plan for Healthy Living, LLC | 100.36% | $2,712,886 | $2,703,048 | $1,869,239 | $0 | Non-Credible | 333 | |
| Elderplan Inc. d/b/a Homefirst | 106.28% | $38,419,515 | $39,246,672 | $28,587,985 | $0 | Partially Credible | 5,419 | |
| Elderserve Health, Inc. | 111.64% | $2,492,068 | $2,232,207 | $1,722,180 | $0 | Non-Credible | 272 | |
| GuildNet, Inc. | 121.69% | $32,573,875 | $26,768,814 | $19,797,994 | $0 | Non-Credible | 3,576 | |
| Healthfirst PHSP, Inc. | 102.31% | $86,829,264 | $89,858,131 | $65,849,356 | $0 | Partially Credible | 12,148 | |
| MetroPlus Health Plan, Inc | 134.22% | $14,368,143 | $10,705,280 | $7,811,143 | $0 | Non-Credible | 1,704 | |
| Partners Health Plan, Inc. FIDA IDD | 102.72% | $140,399,608 | $145,030,704 | $127,955,971 | $0 | Partially Credible | 11,489 | |
| Senior Whole Health of New York, Inc. | 116.04% | $13,967,359 | $12,036,567 | $8,350,226 | $0 | Non-Credible | 1,630 | |
| Village Senior Services Corp. (VillageCare Max) | 70.12% | $1,013,115 | $1,444,916 | $1,138,379 | $0 | Non-Credible | 242 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 104.25% | $114,103,593 | $115,246,455 | $85,981,384 | $0 | Partially Credible | 15,243 | |
| Total | $464,399,124 | $462,800,676 | $361,870,201 | $0 | 54,092 | |||
NOTES:
Please note that the Remittance is for this line of business for one year ONLY based on a MLR Target of 86%.
FIDA IDD MLR is reported on a Calendar Year (CY). FIDA is reported on a State Fiscal Year (SFY).
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
No remittance for plan if Non-Credible
