SFY 2019 - 2020 MC MLR Report Summary
Managed Long-Term Care (MLTC) Partial line of business
- Report also available in Portable Document Format (PDF)
| SFY 2019 - 2020 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. | 93.40% | $454,270,150 | $486,385,939 | $0 | Fully Credible | 95,203 | |
| AgeWell New York, LLC | 90.27% | $693,041,631 | $767,756,662 | $0 | Fully Credible | 145,230 | |
| Catholic Managed Long Term Care, Inc. | 96.25% | $316,141,409 | $328,464,519 | $0 | Fully Credible | 58,925 | |
| Centers Plan for Healthy Living, LLC | 91.57% | $2,036,488,076 | $2,223,874,071 | $0 | Fully Credible | 444,467 | |
| Elderplan Inc. d/b/a Homefirst | 87.87% | $821,134,575 | $934,452,564 | $0 | Fully Credible | 177,281 | |
| Elderserve Health, Inc. | 95.30% | $932,024,979 | $978,016,062 | $0 | Fully Credible | 179,735 | |
| Niagara Advantage Health Plan, LLC (Elderwood Health Plan) | 89.04% | $38,910,589 | $44,807,775 | $0 | Partially Credible | 10,337 | |
| Erie Niagara MLTCP, Inc. (dba Kalos Health) | 100.24% | $82,456,338 | $83,639,020 | $0 | Partially Credible | 17,630 | |
| EverCare, Inc. | 96.95% | $44,463,074 | $46,860,620 | $0 | Partially Credible | 11,818 | |
| Extended MLTC, LLC | 96.79% | $343,201,831 | $354,602,189 | $0 | Fully Credible | 83,081 | |
| Fallon Health Weinberg, Inc. (frmly TAIPP) | 85.48% | $36,095,622 | $43,289,281 | $225,104 | Partially Credible | 11,396 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 91.87% | $1,279,350,118 | $1,392,637,199 | $0 | Fully Credible | 278,531 | |
| Hamaspik Choice, Inc. | 98.93% | $114,283,089 | $117,067,881 | $0 | Partially Credible | 28,387 | |
| Healthfirst PHSP, Inc. (Senior Health Partners) | 95.27% | $915,658,106 | $961,136,607 | $0 | Fully Credible | 180,117 | |
| HealthPlus HP, LLC | 92.60% | $419,882,002 | $453,417,866 | $0 | Fully Credible | 82,089 | |
| iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care | 111.08% | $212,782,878 | $191,551,042 | $0 | Fully Credible | 49,881 | |
| Integra MLTC, Inc | 86.13% | $991,069,654 | $1,150,689,941 | $0 | Fully Credible | 274,592 | |
| MetroPlus Health Plan, Inc | 98.40% | $117,782,971 | $121,488,393 | $0 | Partially Credible | 24,092 | |
| Montefiore HMO LLC | 90.38% | $97,007,671 | $109,207,853 | $0 | Partially Credible | 20,781 | |
| Prime Health Choice, LLC | 91.06% | $17,142,688 | $19,430,220 | $0 | Partially Credible | 6,281 | |
| Senior Network Health, LLC | 93.04% | $20,694,388 | $22,906,627 | $0 | Partially Credible | 6,791 | |
| Senior Whole Health of New York, Inc. | 88.54% | $730,977,493 | $825,593,630 | $0 | Fully Credible | 176,943 | |
| United Healthcare of New York, Inc. | 129.29% | $80,443,451 | $63,178,231 | $0 | Partially Credible | 13,048 | |
| Village Senior Services Corp. (VillageCare Max) | 92.72% | $626,666,626 | $675,910,035 | $0 | Fully Credible | 144,121 | |
| VNA Homecare Options, LLC (d/b/a Nascentia Health Options) | 100.25% | $530,460,595 | $529,153,906 | $0 | Fully Credible | 92,110 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 88.69% | $1,328,927,023 | $1,498,323,124 | $0 | Fully Credible | 231,748 | |
| WellCare of New York, Inc. | 102.70% | $343,425,296 | $334,396,148 | $0 | Fully Credible | 68,647 | |
| Total | $13,624,782,323 | $ 14,758,237,406 | $ 225,104 | 2,913,262 | |||
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
