SFY 2020 - 2021 MC MLR Summary
Medicaid line of business
- Report also available in Portable Document Format (PDF)
| SFY 2020 - 2021 MC MLR Summary | |||||||
|---|---|---|---|---|---|---|---|
| Medicaid line of business | |||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium (Total Denominator) |
Remittance | Credible | MMs | |
| Affinity Health Plan, Inc. | 92.37% | $1,003,172,487 | $1,086,089,874 | $0 | Fully Credible | 2,662,842 | |
| Capital District Physicians Health Plan, Inc (CDPHP) | 93.00% | $461,963,827 | $496,747,692 | $0 | Fully Credible | 1,106,815 | |
| Excellus Health Plan, Inc | 93.00% | $879,896,112 | $946,102,859 | $0 | Fully Credible | 2,326,661 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 91.27% | $6,777,572,103 | $7,426,101,086 | $0 | Fully Credible | 17,932,352 | |
| Health Insurance Plan of Greater New York (Emblem) | 90.83% | $790,817,090 | $870,681,393 | $0 | Fully Credible | 1,683,248 | |
| Healthfirst PHSP, Inc. | 92.56% | $5,709,313,973 | $6,168,515,080 | $0 | Fully Credible | 12,642,215 | |
| Highmark Western and Northeastern New York Inc. (frmly Healthnow) | 91.94% | $230,486,268 | $250,695,962 | $0 | Fully Credible | 409,496 | |
| HealthPlus HP, LLC | 93.98% | $1,643,559,126 | $1,748,838,971 | $0 | Fully Credible | 4,088,144 | |
| Independent Health Association, Inc | 93.00% | $305,104,807 | $328,065,516 | $0 | Fully Credible | 733,927 | |
| MVP Health Plan, Inc. | 93.00% | $931,696,592 | $1,001,837,327 | $0 | Fully Credible | 2,130,659 | |
| MetroPlus Health Plan, Inc | 89.84% | $1,741,238,119 | $1,938,230,841 | $0 | Fully Credible | 4,836,380 | |
| Molina Healthcare of New York, Inc. | 89.28% | $247,853,839 | $277,617,147 | $0 | Fully Credible | 682,311 | |
| United Healthcare of New York, Inc. | 92.06% | $1,797,510,044 | $1,952,614,115 | $0 | Fully Credible | 4,618,884 | |
| WellCare of New York, Inc. | 94.60% | $63,719,519 | $68,516,733 | $0 | Partially Credible | 172,445 | |
| YourCare Health Plan, Inc. | 94.91% | $46,045,617 | $49,514,074 | $0 | Partially Credible | 113,028 | |
| Total | $22,629,949,522 | $24,610,168,670 | $0 | 56,139,407 | |||
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
