1st Source Corporation
Overview
1st Source Corporation sponsors a self-funded health plan that covered 1,221 participants in plan year 2025, about the same as the prior year. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, vision, short-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 1,221 · prior year 1,199
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- 1st Source Corporation Comprehensive Health and Welfare Benefit Plan, plan 503 (1,221 participants)
- Broker compensation
- $191K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| Life Insurance Company of North America | Life, Short-term disability, Long-term disability | 1,161 | $1.0M | $153K |
| Reliastar Life Insurance Company | Accident, Critical Illness, Hospital | 678 | $230K | $39K |
| UnitedHealthcare Insurance Company | Vision | 787 | $114K | — |
| Allone Health EAP, LLC | Employee Assistance Program | 1,241 | $20K | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 1,221 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2025
- Plan sponsor
- 1st Source Corporation
- Sponsor EIN
- 35-1068133
- Plan number
- 503
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 35-1068133 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- 1st Source Corporation Employee Stock Ownership and Profit Sharing Plan
- Type
- 401(k) plan
- Participants
- 1,529
About this data
Source: 1st Source Corporation's Form 5500 filing for plan year 2025 and its Schedule A insurance reports, published by the U.S. Department of Labor. "Self-funded" means the filing reports benefits paid from employer assets or a trust, with no medical insurance contract or with a stop-loss contract. Pharmacy figures are StreamRX estimates based on national averages. StreamRX is not affiliated with 1st Source Corporation.