SFY 2020 - 2021 MC MLR Summary
Medicaid Advantage (MA) line of business
- Report also available in Portable Document Format (PDF)
| SFY 2020 - 2021 MC MLR 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) | 111.72% | $23,030,297 | $21,665,122 | $1,513,517 | $0 | Partially Credible | 14,007 | |
| United Healthcare of New York, Inc. | 48.15% | $13,116,949 | $30,470,930 | $1,546,891 | $585,498 | Partially Credible | 16,244 | |
| WellCare of New York, Inc. | 73.88% | $11,461,190 | $16,737,507 | $500,478 | $60,658 | Partially Credible | 14,134 | |
| Total | $47,608,436 | $68,873,559 | $3,560,886 | $646,156 | 44,385 | |||
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
