Caromont Health, Inc.

Gastonia, NC Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
4,080Participants+14% vs. prior year
$9.7MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#7 of 46Health care in NCBy participants

Overview

Caromont Health, Inc. sponsors a self-funded health plan that covered 4,080 participants in plan year 2025, up 14% 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
4,080 · prior year 3,584
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Caromont Health, Inc. Welfare Benefit Plan, plan 512 (4,080 participants)
Broker compensation
$245K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilityOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Life Insurance Company of North AmericaAccidental Death and Dismemberment, Life, Long-term disability6,223$2.2M$2K
Aetna Life Insurance Co.—4,117$908K$243K
Community Eye CareVision6,075$830K—

Pharmacy benefit estimate

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

$9.7M/ year

Estimated prescription spend: 4,080 participants × $2,371 national average per member. Usually higher once dependents are counted.

$252K–$620K/ year

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

Brands with a generic available$74K–$184K
Lower-cost therapeutic alternatives$107K–$224K
Generic pricing vs. actual cost$46K–$139K
PBM contract terms$24K–$73K
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
Caromont Health, Inc.
Sponsor EIN
58-1636959
Plan number
512
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 58-1636959 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Caromont Health, Inc. Retirement Savings Plan
Type
Defined contribution plan
Participants
7,109

About this data

Source: Caromont Health, 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 Caromont Health, Inc..

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