SFY 2019 - 2020 MC MLR Report Summary
Medicaid Advantage (MA) line of business
- Report also available in Portable Document Format (PDF)
| SFY 2019 - 2020 MC MLR Report Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| Medicaid Advantage (MA) 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 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 97.15% | $20,804,299 | $22,636,086 | $1,585,102 | $0 | Partially Credible | 15,218 | |
| United Healthcare of New York, Inc. | 126.09% | $41,896,918 | $34,258,929 | $775,609 | $0 | Partially Credible | 28,578 | |
| WellCare of New York, Inc. | 99.03% | $21,432,994 | $22,744,897 | $326,637 | $0 | Partially Credible | 18,341 | |
| Total | $84,134,211 | $79,639,912 | $2,687,348 | $0 | 62,137 | |||
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
