Bellin Memorial Hospital
Overview
Bellin Memorial Hospital sponsors a self-funded health plan that covered 4,685 participants in plan year 2024. The plan year starts in October. 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
- 4,685
- Plan year
- Begins October 1 · next renewal October 2027
- Health plans filed
- Bellin Memorial Hospital DBA Bellin Health System's, Inc. Comprehensive Health and Welfare Benefits Plan, plan 512 (4,685 participants)
- Broker compensation
- $76K 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 |
|---|---|---|---|---|
| Unum Life Insurance Company of America | Life, Short-term disability, Long-term disability | 4,741 | $1.2M | $67K |
| Metropolitan Life Insurance Company | Vision | 6,012 | $84K | $9K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 4,685 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
- Bellin Memorial Hospital
- Sponsor EIN
- 39-0884478
- Plan number
- 512
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 39-0884478 in the Department of Labor's EFAST2 Form 5500 search.
About this data
Source: Bellin Memorial Hospital'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 Bellin Memorial Hospital.