SFY 2020 - 2021 MC MLR Summary
MAP line of business
- Report also available in Portable Document Format (PDF)
| SFY 2020 - 2021 MC MLR Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| MAP 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 | |
| AgeWell New York LLC MAP | 101.58% | $2,012,183 | $1,980,839 | $1,478,667 | $0 | Non-Credible | 226 | |
| Centers Plan for Healthy Living, LLC | 96.58% | $6,325,166 | $6,548,961 | $4,845,513 | $0 | Non-Credible | 994 | |
| Elderplan, Inc. d/b/a Homefirst | 89.54% | $153,640,061 | $179,446,621 | $123,466,867 | $0 | Partially Credible | 25,715 | |
| Elderserve MAP dba Riverspring | 100.76% | $2,844,636 | $2,823,314 | $2,241,118 | $0 | Non-Credible | 357 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 99.08% | $6,314,137 | $6,372,528 | $4,508,904 | $0 | Non-Credible | 785 | |
| Healthfirst Healthplan, Inc. | 91.75% | $1,032,357,993 | $1,144,918,234 | $770,439,751 | $0 | Partially Credible | 176,895 | |
| HealthPlus HP, LLC | 89.64% | $603,197 | $672,925 | $558,443 | $0 | Non-Credible | 124 | |
| Senior Whole Health of New York, Inc. | 98.96% | $14,769,742 | $14,924,384 | $11,165,873 | $0 | Non-Credible | 1,557 | |
| Village Senior Services Corp. (VillageCare Max) | 90.36% | $159,066,276 | $183,800,495 | $129,613,056 | $0 | Partially Credible | 27,875 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 91.93% | $249,214,937 | $281,515,946 | $197,614,689 | $0 | Partially Credible | 37,103 | |
| Total | $1,627,148,328 | $1,823,004,247 | $1,245,932,881 | $0 | 271,631 | |||
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
