SFY 2017 - 2018 MC MLR Report Summary

MAP line of business

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SFY 2017 - 2018 MC MLR Report Summary
MAP 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
Elderplan, Inc. d/b/a Homefirst 83.47% $86,285,037 $110,367,064 $77,465,860 $1,959,886 Partially Credible 14,868
New York State Catholic Health Plan, Inc. (Fidelis Legacy) 105.28% $8,963,697 $8,514,366 $5,413,211 $0 Non-Credible 1,272
GuildNet, Inc. 93.59% $42,399,832 $48,071,700 $36,795,531 $0 Partially Credible 14,217
Healthfirst Healthplan, Inc. 92.94% $380,263,360 $421,365,462 $288,472,916 $0 Partially Credible 59,323
HealthPlus HP, LLC 93.55% $87,168 $93,183 $85,618 $0 Non-Credible 24
Senior Whole Health of New York, Inc. 97.98% $9,528,910 $9,725,620 $7,117,900 $0 Non-Credible 1,287
Village Senior Services Corp. (VillageCare Max) 95.23% $7,226,738 $7,588,427 $5,439,345 $0 Non-Credible 1,128
VNS (d/b/a VNSNY Choice) and Subsidiary 80.63% $90,032,045 $118,948,574 $84,913,387 $4,559,849 Partially Credible 17,363
Total   $624,786,787 $724,674,395 $505,703,768   $6,519,735 109,482

NOTES:
Please note that the Remittance is for this line of business for one year ONLY based on a MLR Target of 86%.
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