SFY 2019 - 2020 MC MLR Report Summary
Medicaid line of business
- Report also available in Portable Document Format (PDF)
| SFY 2019 - 2020 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. | 93.31% | $965,982,257 | $1,035,229,428 | $0 | Fully Credible | 2,298,906 | |
| Capital District Physicians Health Plan, Inc (CDPHP) | 95.23% | $413,374,533 | $434,097,134 | $0 | Fully Credible | 957,146 | |
| Crystal Run Health Plan, LLC | 140.68% | $3,287,036 | $2,463,234 | $0 | Partially Credible | 8,230 | |
| Excellus Health Plan, Inc | 95.57% | $823,884,251 | $862,119,110 | $0 | Fully Credible | 2,014,143 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 93.78% | $6,078,879,834 | $6,482,241,376 | $0 | Fully Credible | 14,749,892 | |
| Health Insurance Plan of Greater New York (Emblem) | 93.98% | $757,417,704 | $805,902,157 | $0 | Fully Credible | 1,477,933 | |
| Healthfirst PHSP, Inc. | 95.92% | $5,268,225,720 | $5,492,406,382 | $0 | Fully Credible | 11,113,417 | |
| Highmark Western and Northeastern New York Inc. (frmly Healthnow) | 94.73% | $203,796,306 | $215,129,828 | $0 | Fully Credible | 409,496 | |
| HealthPlus HP, LLC | 97.08% | $1,471,126,684 | $1,515,361,493 | $0 | Fully Credible | 3,687,723 | |
| Independent Health Association, Inc | 94.32% | $295,001,835 | $312,783,334 | $0 | Fully Credible | 657,753 | |
| MVP Health Plan, Inc. | 96.52% | $879,843,181 | $911,611,678 | $0 | Fully Credible | 1,906,138 | |
| MetroPlus Health Plan, Inc | 92.88% | $1,641,159,962 | $1,767,057,651 | $0 | Fully Credible | 4,323,988 | |
| Molina Healthcare of New York, Inc. | 86.35% | $115,173,646 | $135,208,724 | $0 | Partially Credible | 315,789 | |
| United Healthcare of New York, Inc. | 94.89% | $1,955,345,180 | $2,060,757,192 | $0 | Fully Credible | 4,893,223 | |
| WellCare of New York, Inc. | 87.36% | $445,567,254 | $510,035,622 | $0 | Fully Credible | 1,234,452 | |
| YourCare Health Plan, Inc. | 101.34% | $209,356,937 | $206,593,809 | $0 | Fully Credible | 440,213 | |
| Total | $21,527,422,319 | $22,748,998,153 | $0 | 50,488,442 | |||
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
