Medical Loss Ratio Calculation. Within ninety (90) days following the six (6) month claims run-out period following the coverage year, CMS and NYSDOH shall calculate the MLR by dividing the benefit expense by the revenue. The MLR shall be expressed as a percentage rounded to the second decimal point. The FIDA Plan shall have sixty (60) days to review the Medical Loss Ratio Calculation. Each party shall have the right to review all data and methodologies used to calculate the Medical Loss Ratio.
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