SFY 2018 - 2019 MC MLR Report Summary

Managed Long-Term Care (MLTC) Partial line of business

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SFY 2018 - 2019 MC MLR Report Summary
Managed Long-Term Care (MLTC) Partial line of business
Plan MLR AFTER
Credibility
Adjustment
Medical Expense
(Total Numerator)
Premium
(Total Denominator)
Remittance Credible MMs
Aetna Better Health, Inc. 96.64% $366,559,932 $379,291,272 $0 Fully Credible 78,514
AgeWell New York, LLC 90.11% $571,791,742 $634,553,501 $0 Fully Credible 120,784
Catholic Managed Long Term Care, Inc. 95.98% $253,378,526 $263,989,611 $0 Fully Credible 49,127
Centers Plan for Healthy Living, LLC 87.81% $1,678,940,210 $1,912,033,663 $0 Fully Credible 363,105
Elderplan Inc. d/b/a Homefirst 89.56% $719,237,391 $803,096,990 $0 Fully Credible 159,058
Elderserve Health, Inc. 97.16% $775,652,816 $798,306,485 $0 Fully Credible 154,638
Niagara Advantage Health Plan, LLC (Elderwood Health Plan) 89.46% $18,380,119 $21,316,471 $0 Partially Credible 4,679
Erie Niagara MLTCP, Inc. (dba Kalos Health) 95.77% $69,864,843 $74,287,718 $0 Partially Credible 15,723
EverCare, Inc. 95.72% $45,634,324 $48,738,607 $0 Partially Credible 11,537
Extended MLTC, LLC 89.74% $232,741,171 $259,346,043 $0 Fully Credible 64,470
Fallon Health Weinberg, Inc. (frmly TAIPP) 89.78% $30,081,761 $34,383,680 $0 Partially Credible 9,242
New York Quality Healthcare Corporation (Fidelis Care) 95.34% $1,201,658,053 $1,260,435,231 $0 Fully Credible 263,903
GuildNet, Inc. 114.61% $335,153,700 $292,437,474 $0 Fully Credible 58,800
Hamaspik Choice, Inc. 87.87% $100,059,055 $115,674,898 $0 Partially Credible 26,484
Healthfirst PHSP, Inc. (Senior Health Partners) 94.82% $844,129,066 $890,276,451 $0 Fully Credible 176,758
HealthPlus HP, LLC 98.29% $324,972,634 $330,627,487 $0 Fully Credible 68,378
iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care 95.09% $132,290,781 $140,917,967 $0 Partially Credible 31,511
Independence Care System, Inc. (ICS) 109.13% $472,804,895 $433,253,749 $0 Fully Credible 71,610
Integra MLTC, Inc 80.75% $576,792,861 $714,341,692 $37,502,939 Fully Credible 162,678
MetroPlus Health Plan, Inc 94.70% $100,096,748 $107,400,198 $0 Partially Credible 22,438
Montefiore HMO LLC 89.61% $78,817,860 $89,571,739 $0 Partially Credible 18,484
Prime Health Choice, LLC 78.00% $11,563,797 $15,464,218 $1,237,137 Partially Credible 4,726
Senior Network Health, LLC 89.84% $19,146,831 $21,976,652 $0 Partially Credible 6,721
Senior Whole Health of New York, Inc. 92.78% $650,346,572 $700,988,683 $0 Fully Credible 168,953
United Healthcare of New York, Inc. 110.79% $263,760,721 $238,066,146 $0 Fully Credible 46,920
Village Senior Services Corp. (VillageCare Max) 89.74% $528,104,953 $588,471,118 $0 Fully Credible 126,554
VNA Homecare Options, LLC (d/b/a Nascentia Health Options) 99.56% $461,160,439 $463,178,923 $0 Fully Credible 82,726
VNS (d/b/a VNSNY Choice) and Subsidiary 88.10% $779,288,130 $884,553,288 $0 Fully Credible 153,154
WellCare of New York, Inc. 92.87% $311,692,279 $335,611,782 $0 Fully Credible 66,082
Total   $11,954,102,210 $12,852,591,736 $38,740,076   2,587,757

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