SFY 2018 - 2019 MC MLR Report Summary
Managed Long-Term Care (MLTC) Partial line of business
- Report also available in Portable Document Format (PDF)
| SFY 2018 - 2019 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. | 96.64% | $366,559,932 | $379,291,272 | $0 | Fully Credible | 78,514 | |
| AgeWell New York, LLC | 90.11% | $571,791,742 | $634,553,501 | $0 | Fully Credible | 120,784 | |
| Catholic Managed Long Term Care, Inc. | 95.98% | $253,378,526 | $263,989,611 | $0 | Fully Credible | 49,127 | |
| Centers Plan for Healthy Living, LLC | 87.81% | $1,678,940,210 | $1,912,033,663 | $0 | Fully Credible | 363,105 | |
| Elderplan Inc. d/b/a Homefirst | 89.56% | $719,237,391 | $803,096,990 | $0 | Fully Credible | 159,058 | |
| Elderserve Health, Inc. | 97.16% | $775,652,816 | $798,306,485 | $0 | Fully Credible | 154,638 | |
| Niagara Advantage Health Plan, LLC (Elderwood Health Plan) | 89.46% | $18,380,119 | $21,316,471 | $0 | Partially Credible | 4,679 | |
| Erie Niagara MLTCP, Inc. (dba Kalos Health) | 95.77% | $69,864,843 | $74,287,718 | $0 | Partially Credible | 15,723 | |
| EverCare, Inc. | 95.72% | $45,634,324 | $48,738,607 | $0 | Partially Credible | 11,537 | |
| Extended MLTC, LLC | 89.74% | $232,741,171 | $259,346,043 | $0 | Fully Credible | 64,470 | |
| Fallon Health Weinberg, Inc. (frmly TAIPP) | 89.78% | $30,081,761 | $34,383,680 | $0 | Partially Credible | 9,242 | |
| New York Quality Healthcare Corporation (Fidelis Care) | 95.34% | $1,201,658,053 | $1,260,435,231 | $0 | Fully Credible | 263,903 | |
| GuildNet, Inc. | 114.61% | $335,153,700 | $292,437,474 | $0 | Fully Credible | 58,800 | |
| Hamaspik Choice, Inc. | 87.87% | $100,059,055 | $115,674,898 | $0 | Partially Credible | 26,484 | |
| Healthfirst PHSP, Inc. (Senior Health Partners) | 94.82% | $844,129,066 | $890,276,451 | $0 | Fully Credible | 176,758 | |
| HealthPlus HP, LLC | 98.29% | $324,972,634 | $330,627,487 | $0 | Fully Credible | 68,378 | |
| iCircle Services of the Finger Lakes, Inc. - d/b/a iCircle Care | 95.09% | $132,290,781 | $140,917,967 | $0 | Partially Credible | 31,511 | |
| Independence Care System, Inc. (ICS) | 109.13% | $472,804,895 | $433,253,749 | $0 | Fully Credible | 71,610 | |
| Integra MLTC, Inc | 80.75% | $576,792,861 | $714,341,692 | $37,502,939 | Fully Credible | 162,678 | |
| MetroPlus Health Plan, Inc | 94.70% | $100,096,748 | $107,400,198 | $0 | Partially Credible | 22,438 | |
| Montefiore HMO LLC | 89.61% | $78,817,860 | $89,571,739 | $0 | Partially Credible | 18,484 | |
| Prime Health Choice, LLC | 78.00% | $11,563,797 | $15,464,218 | $1,237,137 | Partially Credible | 4,726 | |
| Senior Network Health, LLC | 89.84% | $19,146,831 | $21,976,652 | $0 | Partially Credible | 6,721 | |
| Senior Whole Health of New York, Inc. | 92.78% | $650,346,572 | $700,988,683 | $0 | Fully Credible | 168,953 | |
| United Healthcare of New York, Inc. | 110.79% | $263,760,721 | $238,066,146 | $0 | Fully Credible | 46,920 | |
| Village Senior Services Corp. (VillageCare Max) | 89.74% | $528,104,953 | $588,471,118 | $0 | Fully Credible | 126,554 | |
| VNA Homecare Options, LLC (d/b/a Nascentia Health Options) | 99.56% | $461,160,439 | $463,178,923 | $0 | Fully Credible | 82,726 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 88.10% | $779,288,130 | $884,553,288 | $0 | Fully Credible | 153,154 | |
| WellCare of New York, Inc. | 92.87% | $311,692,279 | $335,611,782 | $0 | Fully Credible | 66,082 | |
| Total | $11,954,102,210 | $12,852,591,736 | $38,740,076 | 2,587,757 | |||
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
