SFY 2017 - 2018 MC MLR Report Summary
Medicaid line of business
- Report also available in Portable Document Format (PDF)
| SFY 2017 - 2018 MC MLR Report Summary | |||||||
|---|---|---|---|---|---|---|---|
| Medicaid line of business | |||||||
| Plan | MLR AFTER Credibility Adjustment |
Medical Expense (Total Numerator) |
Premium (Total Denominator) |
Remittance | Credible | MMs | |
| Affinity Health Plan, Inc. | 94.69% | $1,091,272,723 | $1,152,530,013 | $0 | Fully Credible | 2,631,643 | |
| Capital District Physicians Health Plan, Inc (CDPHP) | 94.58% | $406,472,230 | $429,749,972 | $0 | Fully Credible | 984,308 | |
| Crystal Run Health Plan, LLC | 93.89% | $6,156,974 | $6,949,934 | $0 | Partially Credible | 14,797 | |
| Excellus Health Plan, Inc | 95.25% | $812,942,866 | $853,531,673 | $0 | Fully Credible | 1,989,694 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 91.20% | $5,736,812,562 | $6,290,284,200 | $0 | Fully Credible | 14,372,751 | |
| Health Insurance Plan of Greater New York (Emblem) | 100.23% | $835,733,897 | $833,861,296 | $0 | Fully Credible | 1,755,262 | |
| Healthfirst PHSP, Inc. | 94.46% | $5,029,807,140 | $5,324,595,784 | $0 | Fully Credible | 10,970,370 | |
| Highmark Western and Northeastern New York Inc. (frmly Healthnow) | 98.98% | $176,084,293 | $179,956,083 | $0 | Partially Credible | 330,191 | |
| HealthPlus HP, LLC | 93.92% | $1,611,090,221 | $1,715,377,892 | $0 | Fully Credible | 4,168,827 | |
| Independent Health Association, Inc | 101.30% | $315,129,875 | $311,102,500 | $0 | Fully Credible | 711,492 | |
| MVP Health Plan, Inc. | 96.91% | $882,498,812 | $910,655,281 | $0 | Fully Credible | 1,938,290 | |
| MetroPlus Health Plan, Inc | 92.37% | $1,702,787,774 | $1,843,479,057 | $0 | Fully Credible | 4,491,141 | |
| Molina Healthcare of New York, Inc. | 93.01% | $140,061,047 | $152,307,668 | $0 | Partially Credible | 362,899 | |
| United Healthcare of New York, Inc. | 90.78% | $2,023,517,831 | $2,228,996,895 | $0 | Fully Credible | 5,601,506 | |
| WellCare of New York, Inc. | 85.35% | $400,762,532 | $469,566,107 | $3,052,180 | Fully Credible | 1,197,426 | |
| YourCare Health Plan, Inc. | 94.05% | $220,196,017 | $234,116,779 | $0 | Fully Credible | 502,137 | |
| Total | $21,391,326,794 | $22,937,061,134 | $3,052,180 | 52,022,734 | |||
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
