SFY 2019 - 2020 MC MLR Report Summary
FIDA line of business
- Report also available in Portable Document Format (PDF)
| SFY 2019 - 2020 MC MLR Report 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 | |
| Centers Plan for Healthy Living, LLC | 101.70% | $1,351,684 | $1,329,033 | $920,640 | $0 | Non-Credible | 333 | |
| Elderplan Inc. d/b/a Homefirst | 101.11% | $26,749,775 | $26,456,332 | $19,023,198 | $0 | Non-Credible | 3,124 | |
| Elderserve Health, Inc. | 107.02% | $1,295,189 | $1,210,261 | $973,045 | $0 | Non-Credible | 149 | |
| Healthfirst PHSP, Inc. | 102.99% | $66,069,652 | $68,895,850 | $49,354,081 | $0 | Partially Credible | 8,603 | |
| Partners Health Plan, Inc. FIDA IDD | 104.48% | $212,260,124 | $213,669,558 | $189,712,095 | $0 | Partially Credible | 15,954 | |
| Senior Whole Health of New York, Inc. | 100.63% | $9,696,524 | $9,635,960 | $6,969,019 | $0 | Non-Credible | 1,068 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 107.98% | $80,742,582 | $79,658,683 | $60,077,652 | $0 | Partially Credible | 9,744 | |
| Total | $398,165,531 | $400,855,677 | $327,029,730 | $0 | 38,975 | |||
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 Premium.
No remittance for plan if Non-Credible
