SFY 2021 - 2022 MC MLR Summary
HARP line of business
| SFY 2021 - 2022 MC MLR Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| HARP 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 | |
| Affinity Health Plan, Inc. | 88.92% | $81,883,967 | $95,445,157 | $95,445,157 | $76,356 | Partially Credible | 43,057 | |
| Anthem HP, LLC (HealthPlus) | 88.05% | $188,467,298 | $219,175,499 | $218,978,505 | $2,080,296 | Partially Credible | 92,536 | |
| Capital District Physicians Health Plan, Inc (CDPHP) | 94.37% | $93,396,408 | $101,966,560 | $101,966,560 | $0 | Partially Credible | 55,071 | |
| Excellus Health Plan, Inc. | 92.34% | $217,494,519 | $240,200,749 | $240,200,749 | $0 | Partially Credible | 137,024 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 87.09% | $1,181,957,673 | $1,357,113,035 | $1,354,128,783 | $25,863,860 | Fully Credible | 632,983 | |
| Health Insurance Plan of Greater New York (Emblem) | 104.38% | $147,808,544 | $145,157,481 | $145,157,481 | $0 | Partially Credible | 66,655 | |
| Healthfirst PHSP, Inc. | 90.04% | $942,372,550 | $1,046,572,357 | $1,046,572,357 | $0 | Fully Credible | 385,101 | |
| Independent Health Association, Inc. | 90.78% | $60,219,519 | $69,038,536 | $69,038,536 | $0 | Partially Credible | 33,721 | |
| MVP Health Plan, Inc. | 98.50% | $192,004,069 | $199,094,606 | $199,094,606 | $0 | Partially Credible | 92,669 | |
| MetroPlus Health Plan, Inc. | 93.17% | $390,927,797 | $427,094,225 | $425,023,321 | $0 | Partially Credible | 164,607 | |
| Molina Healthcare of New York, Inc. | 87.39% | $133,173,288 | $156,601,411 | $156,601,411 | $2,521,283 | Partially Credible | 77,484 | |
| United Healthcare of New York, Inc. | 92.25% | $240,194,075 | $265,588,444 | $265,588,444 | $0 | Partially Credible | 131,275 | |
| Total | $3,869,899,708 | $4,323,048,059 | $4,317,795,910 | $30,541,794 | 1,912,183 | |||
NOTES:
Please note that the Remittance is for this line of business for one year ONLY based on a MLR Target of 89%.
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
