Amesbury Industries, Inc.
Overview
Amesbury Industries, Inc. sponsors a self-funded health plan that covered 1,248 participants in plan year 2024. 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
- 1,248
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Amesbury Truth Medical Plan Document and Summary Plan Description, plan 501 (1,248 participants)
- Broker compensation
- $164K 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 |
|---|---|---|---|---|
| RX Benefits | Prescription drug | 819 | $2.4M | $40K |
| Hartford Life and Accident | Life, Short-term disability, Long-term disability | 1,224 | $1.1M | $59K |
| Delta Dental of South Dakota | Dental | 1,547 | $598K | $23K |
| Unum Insurance Company | Accident, Hospital Indemnity, Specified Disease | 195 | $112K | $16K |
| VSP | Vision | 774 | $83K | $10K |
| Lifeworks | EAP | 1,267 | $56K | — |
| Provident Life and Accident Insurance Company | Disability | 47 | $29K | $16K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 1,248 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 2024
- Plan sponsor
- Amesbury Industries, Inc.
- Sponsor EIN
- 11-2557875
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 11-2557875 in the Department of Labor's EFAST2 Form 5500 search.
About this data
Source: Amesbury Industries, Inc.'s Form 5500 filing for plan year 2024 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 Amesbury Industries, Inc..