SFY 2021 - 2022 MC MLR Summary
Managed Long-Term Care (MLTC) Partial line of business
| SFY 2021 - 2022 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. | 92.64% | $303,791,655 | $327,911,879 | $0 | Fully Credible | 69,438 | |
| AgeWell New York, LLC | 92.75% | $664,825,132 | $716,775,627 | $0 | Fully Credible | 155,085 | |
| Anthem HP, LLC (HealthPlus) | 87.10% | $257,299,047 | $295,423,348 | $0 | Fully Credible | 60,633 | |
| Catholic Managed Long Term Care, Inc. (Archcare Community Life) | 93.31% | $245,449,633 | $263,049,653 | $0 | Fully Credible | 54,776 | |
| Centers Plan for Healthy Living, LLC | 94.14% | $2,247,489,494 | $2,387,277,623 | $0 | Fully Credible | 545,622 | |
| Elderplan Inc. d/b/a Homefirst | 88.34% | $663,376,760 | $750,931,997 | $0 | Fully Credible | 164,733 | |
| Elderserve Health, Inc. | 99.38% | $904,558,774 | $910,190,162 | $0 | Fully Credible | 181,111 | |
| Niagara Advantage Health Plan, LLC (Elderwood Health Plan) | 88.22% | $32,100,961 | $37,250,951 | $0 | Partially Credible | 12,110 | |
| Erie Niagara MLTCP, Inc. (dba Kalos Health) | 79.35% | $19,724,793 | $25,671,464 | $1,707,152 | Partially Credible | 7,548 | |
| Extended MLTC, LLC | 101.94% | $253,849,782 | $249,020,544 | $0 | Fully Credible | 70,192 | |
| Fallon Health Weinberg, Inc. (frmly TAIPP) | 67.24% | $20,160,295 | $30,997,279 | $5,815,090 | Partially Credible | 10,297 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 86.63% | $851,089,579 | $982,446,861 | $0 | Fully Credible | 228,446 | |
| Hamaspik Choice, Inc. | 85.92% | $75,607,121 | $89,501,853 | $71,601 | Partially Credible | 24,322 | |
| Healthfirst PHSP, Inc. (Senior Health Partners) | 96.38% | $559,712,663 | $580,748,157 | $0 | Fully Credible | 126,287 | |
| iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care | 80.92% | $119,996,161 | $150,178,358 | $7,629,061 | Partially Credible | 43,662 | |
| Integra MLTC, Inc. | 93.39% | $1,700,227,801 | $1,820,601,519 | $0 | Fully Credible | 478,473 | |
| MetroPlus Health Plan, Inc. | 89.42% | $60,713,839 | $69,190,446 | $0 | Partially Credible | 16,972 | |
| Montefiore HMO LLC | 96.77% | $83,137,931 | $87,395,426 | $0 | Partially Credible | 17,898 | |
| Prime Health Choice, LLC | 82.86% | $17,039,470 | $21,245,322 | $667,103 | Partially Credible | 6,979 | |
| Senior Network Health, LLC | 79.96% | $9,395,590 | $12,251,560 | $739,994 | Partially Credible | 4,539 | |
| Senior Whole Health of New York, Inc. | 90.88% | $626,073,252 | $688,926,767 | $0 | Fully Credible | 161,903 | |
| Village Senior Services Corp. (VillageCare Max) | 87.98% | $603,743,313 | $686,258,355 | $0 | Fully Credible | 160,675 | |
| VNA Homecare Options, LLC (d/b/a Nascentia Health Options) | 79.39% | $119,043,225 | $152,038,831 | $10,049,767 | Partially Credible | 39,398 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 88.70% | $1,242,239,602 | $1,400,527,064 | $0 | Fully Credible | 258,662 | |
| Total | $11,720,951,263 | $12,786,053,434 | $28,543,761 | 2,911,512 | |||
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
