SFY 2018 - 2019 MC MLR Report Summary
Medicaid Advantage (MA) line of business
- Report also available in Portable Document Format (PDF)
| SFY 2018 - 2019 MC MLR Report Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| Medicaid Advantage (MA) 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 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 96.39% | $22,904,277 | $25,089,371 | $1,757,474 | $0 | Partially Credible | 16,243 | |
| United Healthcare of New York, Inc. | 115.45% | $50,749,567 | $45,357,721 | $2,835,843 | $0 | Partially Credible | 33,640 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 100.30% | $3,976,934 | $3,965,166 | $309,399 | $0 | Non-Credible | 3,797 | |
| WellCare of New York, Inc. | 106.40% | $28,749,303 | $28,140,370 | $2,056,525 | $0 | Partially Credible | 22,327 | |
| Total | $106,380,081 | $102,552,628 | $6,959,241 | $0 | 76,007 | |||
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
Please note that Medicaid Advantage line of business has a Calendar Year (CY) 1/1-12/31 rating period.
Updated 11/6/2023
