City Year, Inc.
Overview
City Year, Inc. sponsors a self-funded health plan that covered 801 participants in plan year 2025, down 13% 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
- 801 · prior year 917
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- City Year, Inc. Welfare Benefit Plan, plan 503 (801 participants)
- Broker compensation
- $13K 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 |
|---|---|---|---|---|
| Prudential Insurance Company of America | Life, Long-term disability | 662 | $49K | $13K |
| Eyemed Vision Care on Behalf of Fidelity Security Life Insurance Co. | Vision | 982 | $36K | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 801 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
- City Year, Inc.
- Sponsor EIN
- 22-2882549
- Plan number
- 503
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 22-2882549 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- City Year 401(k) Savings Plan
- Type
- 401(k) plan
- Participants
- 1,403
About this data
Source: City Year, 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 City Year, Inc..