SFY 2017 - 2018 MC MLR Report Summary

Managed Long-Term Care (MLTC) Partial line of business

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SFY 2017 - 2018 MC MLR Report 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. 95.88% $248,380,912 $259,067,326 $0 Fully Credible 56,468
AgeWell New York, LLC 91.33% $461,071,093 $504,854,826 $0 Fully Credible 105,732
Catholic Managed Long Term Care, Inc. 90.74% $164,331,107 $183,400,447 $0 Partially Credible 35,658
Centers Plan for Healthy Living, LLC 87.83% $1,029,480,093 $1,172,087,142 $0 Fully Credible 244,635
Elderplan Inc. d/b/a Homefirst 88.47% $628,601,559 $710,528,161 $0 Fully Credible 149,431
Elderserve Health, Inc. 92.74% $614,187,019 $662,293,969 $0 Fully Credible 135,769
Niagara Advantage Health Plan, LLC (Elderwood Health Plan) 91.02% $8,032,564 $9,320,598 $0 Partially Credible 1,928
Erie Niagara MLTCP, Inc. (dba Kalos Health) 94.46% $59,123,157 $63,855,892 $0 Partially Credible 14,030
EverCare, Inc. 101.93% $40,132,317 $40,233,695 $0 Partially Credible 10,493
Extended MLTC, LLC 88.20% $118,275,312 $135,842,279 $0 Partially Credible 36,586
Fallon Health Weinberg, Inc. (frmly TAIPP) 98.45% $21,567,348 $22,508,773 $0 Partially Credible 7,090
New York State Catholic Health Plan, Inc. (Fidelis Legacy) 89.81% $1,007,184,461 $1,121,519,863 $0 Fully Credible 234,490
GuildNet, Inc. 104.25% $622,486,696 $597,110,805 $0 Fully Credible 119,299
Hamaspik Choice, Inc. 89.28% $87,320,253 $99,386,802 $0 Partially Credible 24,823
HealthPlus HP, LLC 96.07% $251,663,849 $261,967,026 $0 Fully Credible 55,250
iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care 93.21% $89,360,166 $97,360,792 $0 Partially Credible 24,565
Independence Care System, Inc. (ICS) 100.86% $454,187,862 $450,325,452 $0 Fully Credible 78,628
Integra MLTC, Inc 78.18% $310,443,491 $397,069,993 $31,050,873 Fully Credible 91,491
MetroPlus Health Plan, Inc 89.07% $82,303,289 $94,068,574 $0 Partially Credible 19,943
Montefiore HMO LLC 82.75% $63,867,265 $78,782,057 $2,560,417 Partially Credible 16,739
Prime Health Choice, LLC 70.15% $8,037,113 $12,076,785 $1,914,170 Partially Credible 3,689
Senior Health Partners 89.32% $716,252,744 $801,930,224 $0 Fully Credible 169,008
Senior Network Health, LLC 87.35% $15,282,020 $18,078,140 $0 Partially Credible 6,323
Senior Whole Health of New York, Inc. 94.59% $559,345,183 $591,323,857 $0 Fully Credible 158,965
United Healthcare of New York, Inc. 103.94% $219,133,324 $212,995,403 $0 Partially Credible 40,938
Village Senior Services Corp. (VillageCare Max) 90.64% $395,984,166 $436,896,920 $0 Fully Credible 106,061
VNA Homecare Options, LLC (d/b/a Nascentia Health Options) 91.62% $317,158,518 $346,170,657 $0 Fully Credible 63,962
VNS (d/b/a VNSNY Choice) and Subsidiary 89.53% $711,287,362 $794,481,093 $0 Fully Credible 152,828
WellCare of New York, Inc. 95.82% $287,169,537 $299,685,544 $0 Fully Credible 68,518
Total   $9,591,649,780 $10,475,223,096   $35,525,461 2,233,340

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