SFY 2021 - 2022 MC MLR Summary
MAP line of business
| SFY 2021 - 2022 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 | 101.00% | $4,635,320 | $4,589,521 | $3,291,055 | $0 | Non-Credible | 682 | |
| Anthem HP, LLC (HealthPlus) | 77.55% | $5,500,865 | $7,093,497 | $6,207,757 | $0 | Non-Credible | 1,182 | |
| Centers Plan for Healthy Living, LLC | 85.27% | $44,869,087 | $57,438,605 | $43,425,506 | $317,006 | Partially Credible | 8,457 | |
| Elderplan, Inc. d/b/a Homefirst | 87.62% | $198,204,322 | $235,850,512 | $160,910,452 | $0 | Partially Credible | 33,199 | |
| Elderserve MAP dba Riverspring | 106.02% | $6,686,298 | $6,306,645 | $4,476,063 | $0 | Non-Credible | 907 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 89.62% | $9,791,198 | $10,925,499 | $7,561,399 | $0 | Non-Credible | 1,634 | |
| Hamaspik, Inc. | 90.65% | $7,860,117 | $8,670,960 | $4,946,916 | $0 | Non-Credible | 1,320 | |
| Healthfirst Healthplan, Inc. | 91.80% | $1,357,764,008 | $1,501,790,098 | $987,720,359 | $0 | Partially Credible | 235,096 | |
| Senior Whole Health of New York, Inc. | 109.99% | $13,110,741 | $11,919,541 | $8,235,998 | $0 | Non-Credible | 1,345 | |
| Village Senior Services Corp. (VillageCare Max) | 97.21% | $209,212,475 | $223,243,845 | $156,922,871 | $0 | Partially Credible | 35,202 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 92.05% | $258,205,997 | $291,306,885 | $200,494,680 | $0 | Partially Credible | 36,803 | |
| Total | $2,115,840,429 | $2,359,135,607 | $1,584,193,055 | $317,006 | 355,827 | |||
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
