SFY 2020 - 2021 MC MLR Summary
Managed Long-Term Care (MLTC) Partial line of business
- Report also available in Portable Document Format (PDF)
| SFY 2020 - 2021 MC MLR Summary | |||||||
|---|---|---|---|---|---|---|---|
| Managed Long-Term Care (MLTC) Partial line of business | |||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium (Total Denominator) |
Remittance | Credible | MMs | |
| Aetna Better Health, Inc. | 87.14% | $335,778,791 | $385,324,602 | $0 | Fully Credible | 83,069 | |
| AgeWell New York, LLC | 87.05% | $611,589,261 | $702,573,065 | $0 | Fully Credible | 147,393 | |
| Catholic Managed Long Term Care, Inc. | 90.22% | $247,836,913 | $274,704,066 | $0 | Fully Credible | 54,423 | |
| Centers Plan for Healthy Living, LLC | 88.20% | $2,049,459,078 | $2,323,722,112 | $0 | Fully Credible | 506,994 | |
| Elderplan Inc. d/b/a Homefirst | 87.00% | $683,842,430 | $786,004,033 | $0 | Fully Credible | 173,815 | |
| Elderserve Health, Inc. | 93.31% | $864,624,876 | $926,606,734 | $0 | Fully Credible | 180,840 | |
| Niagara Advantage Health Plan, LLC (Elderwood Health Plan) | 87.00% | $29,437,010 | $33,834,886 | $0 | Partially Credible | 11,102 | |
| Erie Niagara MLTCP, Inc. (dba Kalos Health) | 89.00% | $39,489,833 | $45,389,677 | $0 | Partially Credible | 12,530 | |
| Extended MLTC, LLC | 95.04% | $286,500,069 | $301,438,907 | $0 | Fully Credible | 79,413 | |
| Fallon Health Weinberg, Inc. (frmly TAIPP) | 89.13% | $23,062,891 | $26,511,337 | $0 | Partially Credible | 10,928 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 88.14% | $1,035,886,170 | $1,175,292,782 | $0 | Fully Credible | 259,680 | |
| Hamaspik Choice, Inc. | 88.39% | $82,582,512 | $94,923,002 | $0 | Partially Credible | 26,077 | |
| Healthfirst PHSP, Inc. (Senior Health Partners) | 90.35% | $697,389,019 | $771,866,529 | $0 | Fully Credible | 158,351 | |
| HealthPlus HP, LLC | 86.52% | $310,549,347 | $358,943,194 | $0 | Fully Credible | 71,346 | |
| iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care | 88.31% | $166,388,548 | $188,420,006 | $0 | Fully Credible | 49,899 | |
| Integra MLTC, Inc | 89.64% | $1,363,527,636 | $1,521,099,057 | $0 | Fully Credible | 399,536 | |
| MetroPlus Health Plan, Inc | 93.63% | $82,824,691 | $89,958,856 | $0 | Partially Credible | 20,477 | |
| Montefiore HMO LLC | 91.91% | $85,142,439 | $94,266,868 | $0 | Partially Credible | 19,422 | |
| Prime Health Choice, LLC | 89.64% | $17,441,892 | $20,048,243 | $0 | Partially Credible | 7,057 | |
| Senior Network Health, LLC | 90.01% | $12,722,815 | $14,623,233 | $0 | Partially Credible | 5,580 | |
| Senior Whole Health of New York, Inc. | 87.00% | $575,355,949 | $661,328,883 | $0 | Fully Credible | 159,405 | |
| Village Senior Services Corp. (VillageCare Max) | 87.00% | $571,570,450 | $656,997,558 | $0 | Fully Credible | 154,520 | |
| VNA Homecare Options, LLC (d/b/a Nascentia Health Options) | 87.00% | $223,790,022 | $257,243,320 | $0 | Fully Credible | 54,416 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 87.28% | $1,212,618,761 | $1,389,427,988 | $0 | Fully Credible | 246,566 | |
| WellCare of New York, Inc. | 98.20% | $57,510,077 | $59,904,459 | $0 | Partially Credible | 10,173 | |
| Total | $ 11,666,921,480 | $ 13,160,453,397 | $ - | $ 2,903,012 | |||
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
