Adelphoi USA, Inc.
Overview
Adelphoi USA, Inc. sponsors a self-funded health plan that covered 669 participants in plan year 2025, up 41% from the prior year. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, vision, long-term disability, and more.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 669 · prior year 475
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Adelphoi USA, Inc. Employee Welfare Benefit Plan, plan 501 (669 participants)
- Broker compensation
- $28K 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 |
|---|---|---|---|---|
| Reliance Standard Life Insurance Company | Life, Long-term disability | 669 | $139K | $15K |
| Colonial Life and Accident Insurance Company | Accident, Critical Illness, Hospital | 83 | $96K | $12K |
| Vision Benefits of America | Vision | 689 | $62K | $928 |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 669 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
- Adelphoi USA, Inc.
- Sponsor EIN
- 23-7170997
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 23-7170997 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Adelphoi USA, Inc. Tax Deferred Annuity Plan
- Type
- Defined contribution plan
- Participants
- 1,072
About this data
Source: Adelphoi USA, Inc.'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 Adelphoi USA, Inc..