SFY 2022 - 2023 MC MLR Summary
Managed Long-Term Care (MLTC) Partial line of business
| SFY 2022 - 2023 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. | 95.68% | $310,412,466 | $324,445,331 | $0 | Fully Credible | 65,742 | |
| AgeWell New York, LLC | 96.84% | $351,319,503 | $362,793,352 | $0 | Fully Credible | 78,335 | |
| Anthem HP, LLC (HealthPlus) | 94.95% | $1,027,843,448 | $1,082,472,251 | $0 | Fully Credible | 241,359 | |
| Catholic Managed Long Term Care, Inc. (Archcare Community Life) | 94.55% | $286,070,913 | $302,569,809 | $0 | Fully Credible | 61,249 | |
| Centers Plan for Healthy Living, LLC | 98.61% | $2,573,101,717 | $2,609,322,651 | $0 | Fully Credible | 577,779 | |
| Elderplan Inc. d/b/a Homefirst | 89.68% | $799,827,806 | $891,842,279 | $0 | Fully Credible | 189,297 | |
| Elderserve Health, Inc. | 101.42% | $966,977,472 | $953,446,766 | $0 | Fully Credible | 185,575 | |
| Niagara Advantage Health Plan, LLC (Elderwood Health Plan) | 95.20% | $40,492,617 | $43,442,001 | $0 | Partially Credible | 12,673 | |
| Erie Niagara MLTCP, Inc. (dba Kalos Health) | 80.26% | $17,754,955 | $22,913,315 | $1,315,224 | Partially Credible | 6,527 | |
| EverCare, Inc. | 93.18% | $43,624,552 | $47,934,099 | $0 | Partially Credible | 10,588 | |
| Extended MLTC, LLC | 103.52% | $260,541,225 | $251,671,748 | $0 | Fully Credible | 66,250 | |
| Fallon Health Weinberg, Inc. (frmly TAIPP) | 76.97% | $22,362,837 | $29,920,673 | $2,701,837 | Partially Credible | 9,912 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 91.51% | $846,919,997 | $925,473,537 | $0 | Fully Credible | 209,775 | |
| Hamaspik Choice, Inc. | 83.69% | $79,288,371 | $96,430,257 | $2,227,539 | Partially Credible | 23,436 | |
| Healthfirst PHSP, Inc. (Senior Health Partners) | 97.19% | $532,855,394 | $548,277,743 | $0 | Fully Credible | 110,398 | |
| iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care | 94.02% | $133,749,268 | $143,854,536 | $0 | Partially Credible | 42,078 | |
| Integra MLTC, Inc. | 96.15% | $1,331,929,529 | $1,385,258,371 | $0 | Fully Credible | 342,316 | |
| MetroPlus Health Plan, Inc. | 85.07% | $61,340,355 | $73,593,493 | $684,419 | Partially Credible | 15,820 | |
| Montefiore HMO LLC | 104.31% | $88,369,187 | $86,101,979 | $0 | Partially Credible | 16,567 | |
| Prime Health Choice, LLC | 93.13% | $18,820,313 | $20,822,224 | $0 | Partially Credible | 6,651 | |
| Senior Network Health, LLC | 88.52% | $9,755,207 | $11,475,684 | $0 | Partially Credible | 3,831 | |
| Senior Whole Health of New York, Inc. | 94.56% | $1,061,336,409 | $1,122,389,159 | $0 | Fully Credible | 239,154 | |
| Village Senior Services Corp. (VillageCare Max) | 91.62% | $736,653,369 | $804,022,714 | $0 | Fully Credible | 183,919 | |
| VNA Homecare Options, LLC (d/b/a Nascentia Health Options) | 87.34% | $130,863,854 | $151,630,257 | $0 | Partially Credible | 42,829 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 92.81% | $1,410,658,475 | $1,519,908,822 | $0 | Fully Credible | 269,373 | |
| Total | $13,142,869,240 | $13,812,013,051 | $6,929,019 | 3,011,433 | |||
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
