SFY 2017 - 2018 MC MLR Report Summary
FIDA line of business
- Report also available in Portable Document Format (PDF)
| SFY 2017 - 2018 MC MLR Report Summary | ||||||||
|---|---|---|---|---|---|---|---|---|
| FIDA 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 | |
| Aetna Better Health, Inc. | 96.65% | $3,091,617 | $3,198,707 | $2,175,328 | $0 | Non-Credible | 455 | |
| AgeWell New York, LLC | 115.40% | $18,491,774 | $16,024,112 | $11,230,893 | $0 | Non-Credible | 2,088 | |
| Centers Plan for Healthy Living, LLC | 108.54% | $2,450,759 | $2,257,887 | $1,519,630 | $0 | Non-Credible | 314 | |
| Elderplan Inc. d/b/a Homefirst | 102.76% | $33,429,574 | $32,532,553 | $23,436,182 | $0 | Non-Credible | 4,839 | |
| Elderserve Health, Inc. | 108.80% | $1,234,095 | $1,134,259 | $835,373 | $0 | Non-Credible | 147 | |
| New York State Catholic Health Plan, Inc. (Fidelis Legacy) | 100.12% | $20,397,483 | $20,372,537 | $14,675,461 | $0 | Non-Credible | 2,782 | |
| GuildNet, Inc. | 118.12% | $56,247,715 | $50,927,826 | $38,783,022 | $0 | Partially Credible | 7,188 | |
| Healthfirst PHSP, Inc. | 99.30% | $74,916,774 | $80,250,081 | $58,200,077 | $0 | Partially Credible | 11,385 | |
| Independence Care System, Inc. (ICS) | 98.12% | $8,606,011 | $8,771,172 | $7,008,991 | $0 | Non-Credible | 1,139 | |
| MetroPlus Health Plan, Inc | 109.24% | $15,038,166 | $13,766,058 | $9,899,971 | $0 | Non-Credible | 2,292 | |
| Partners Health Plan, Inc. FIDA IDD | 103.85% | $82,012,950 | $85,346,969 | $74,971,818 | $0 | Partially Credible | 6,972 | |
| Senior Whole Health of New York, Inc. | 110.19% | $12,624,641 | $11,457,040 | $7,808,614 | $0 | Non-Credible | 1,696 | |
| Village Senior Services Corp. (VillageCare Max) | 76.94% | $1,670,767 | $2,171,575 | $1,631,334 | $0 | Non-Credible | 223 | |
| VNS (d/b/a VNSNY Choice) and Subsidiary | 98.50% | $123,536,915 | $131,946,171 | $96,830,486 | $0 | Partially Credible | 17,864 | |
| Total | $453,749,241 | $460,156,947 | $349,007,181 | $0 | 59,384 | |||
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 FIDA IDD line of business has a Calendar Year (CY) 1/1-12/31 rating period.
Updated 11/6/2023
