Ashtabula County Medical Center
Overview
Ashtabula County Medical Center sponsors a self-funded health plan that covered 1,129 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
- 1,129 · prior year 1,120
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Ashtabula County Medical Center Welfare Benefit Plan, plan 507 (1,129 participants)
- Broker compensation
- $77K 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 |
|---|---|---|---|---|
| Delta Dental of Ohio | Dental | 1,923 | $659K | — |
| United of Omaha Life Insurance Company | Life, Short-term disability, Long-term disability | 1,128 | $431K | $57K |
| Metropolitan Life Insurance Company | Vision | 1,715 | $101K | $10K |
| Aetna Life Insurance Co. | Accident, Critical Illness | 450 | $87K | $9K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 1,129 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
- Ashtabula County Medical Center
- Sponsor EIN
- 34-0726081
- Plan number
- 507
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 34-0726081 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Acmc System Savings Investment Plan
- Type
- Defined contribution plan
- Participants
- 2,196
About this data
Source: Ashtabula County Medical Center'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 Ashtabula County Medical Center.