SFY 2022 - 2023 MC MLR Summary
HARP line of business
| SFY 2022 - 2023 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 | |
| Anthem HP, LLC (HealthPlus) | 90.82% | $204,963,855 | $230,857,500 | $229,127,735 | $0 | Partially Credible | 93,946 | |
| Capital District Physicians Health Plan, Inc (CDPHP) | 94.90% | $98,666,770 | $107,011,605 | $107,011,605 | $0 | Partially Credible | 58,880 | |
| Excellus Health Plan, Inc. | 90.25% | $229,190,073 | $258,976,549 | $258,976,549 | $0 | Partially Credible | 144,013 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 91.98% | $1,314,146,929 | $1,428,781,281 | $1,416,322,022 | $0 | Fully Credible | 666,875 | |
| Health Insurance Plan of Greater New York (Emblem) | 95.96% | $146,124,239 | $156,378,818 | $156,378,818 | $0 | Partially Credible | 68,532 | |
| Healthfirst PHSP, Inc. | 92.58% | $1,007,549,329 | $1,088,254,593 | $1,088,254,593 | $0 | Fully Credible | 391,919 | |
| Independent Health Association, Inc. | 98.21% | $64,745,392 | $68,366,111 | $68,366,111 | $0 | Partially Credible | 34,761 | |
| MVP Health Plan, Inc. | 100.11% | $209,282,705 | $213,343,476 | $213,343,476 | $0 | Partially Credible | 95,564 | |
| MetroPlus Health Plan, Inc. | 92.72% | $396,064,247 | $434,914,530 | $430,974,054 | $0 | Partially Credible | 163,566 | |
| Molina Healthcare of New York, Inc. | 87.18% | $229,173,640 | $268,664,592 | $268,664,592 | $4,889,696 | Partially Credible | 119,858 | |
| United Healthcare of New York, Inc. | 90.69% | $237,564,502 | $267,303,881 | $261,250,368 | $0 | Partially Credible | 131,881 | |
| Total | $4,137,471,680 | $4,522,852,936 | $4,498,669,922 | $4,889,696 | 1,969,795 | |||
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
