Major Rating Factors:
Weak profitability index (0.9 on a scale of 0 to 10) with 13.3 million in losses in the last three years. Average return on equity over the last five years has been poor at -8.3%. Weak overall results on stability tests (1.6) based on an excessive 50% enrollment growth during the period, a decline in the number of member physicians during 2021 and rapid premium growth over the last five years. Rating is significantly influenced by the weak financial results of EmblemHealth Inc. Weak liquidity (1.5) as a spike in claims may stretch capacity.
Other Rating Factors:
Excellent overall capitalization (7.0) based on good current risk-adjusted capital (severe loss scenario) despite some fluctuation in capital levels. Excellent quality investment portfolio (8.9) containing small junk bond exposure.
Principal Lines of Business:
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Licensed in:
NY
Principal Enrollment Breakdown:
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Other Highlights
Medical Loss Ratio
Medical Expense
Per Member Per Month ($)
Provider Compensation ($000)
Capitation Pay
Fee For Service
Contractual Pay
Salary
Bonus
Other
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Member Physicians
Enrollment
Total Patient Encounters
Physician
Non-Physician
Corporate Info
Group Affiliation
EmblemHealth Inc
Investment Rating
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Company Address
55 Water Street
New York, NY 10041
New York, NY 10041
Phone Number
(646) 447-5000
NAIC Number
60094
Website
Largest Affiliates
