Appalachian Regional Healthcare System

Boone, NC Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
1,227Participants+21% vs. prior year
$2.9MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#18 of 46Health care in NCBy participants

Overview

Appalachian Regional Healthcare System sponsors a self-funded health plan that covered 1,227 participants in plan year 2025, up 21% from 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
1,227 · prior year 1,014
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Appalachian Regional Healthcare System, Inc. Health and Welfare Benefit Plan, plan 501 (1,227 participants)
Broker compensation
$91K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityPrepaid legalLong-term disabilityDeath benefits

Insurance carriers

Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.

CarrierCoverageCoveredPremiumBroker comp
Hartford Life and AccidentLife, Long-term disability1,227$424K$74K
Community Eye Care, LLCVision1,349$147K$15K
Arag Insurance CompanyLegal158$16K$2K
Relymd LLCTelehealth964$13K—
UnumLife1,227——

Pharmacy benefit estimate

StreamRX estimate for a plan this size. Not based on this plan's claims.

$2.9M/ year

Estimated prescription spend: 1,227 participants × $2,371 national average per member. Usually higher once dependents are counted.

$76K–$186K/ year

Typical savings opportunity found in independent reviews of plans this size.

Brands with a generic available$22K–$55K
Lower-cost therapeutic alternatives$32K–$67K
Generic pricing vs. actual cost$14K–$42K
PBM contract terms$7K–$22K
The DOL's PBM fee disclosure rule first applies to this plan for the plan year beginning January 2028: semiannual PBM compensation reports and an annual audit right.

Form 5500 filing details

Filing
Form 5500 with Schedule A, plan year 2025
Plan sponsor
Appalachian Regional Healthcare System
Sponsor EIN
20-1067022
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 20-1067022 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Appalachian Regional Healthcare System 403(b) Retirement Savings Plan
Type
Defined contribution plan
Participants
1,887

About this data

Source: Appalachian Regional Healthcare System'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 Appalachian Regional Healthcare System.

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