Community Options Inc.

Princeton, NJ Health careNAICS 624200

Self-funded health planPlan year 2025Renews January
4,131Participants+13% vs. prior year
$9.8MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#6 of 53Health care in NJBy participants

Overview

Community Options Inc. sponsors a self-funded health plan that covered 4,131 participants in plan year 2025, up 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
4,131 · prior year 3,650
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Community Options Inc. Employee Health and Welfare Plan, plan 501 (4,131 participants)
Broker compensation
$509K 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
Sun Life Assurance Company of CanadaLife, Short-term disability, Long-term disability4,131$2.3M$217K
Delta Dental of NJ, Inc.Dental1,572$987K$94K
Colonial Life & Accident Insurance CompanyLife, Short-term disability636$637K$144K
Metropolitan Life Insurance CompanyVision2,458$128K$15K
Pre-Paid Legal Services, Inc. DBA LegalshieldLegal Services Plan Memberships567$102K$22K
Sun Life and Health Insurance Company (US)Short-term disability533$96K$4K
The Paul Revere Life Insurance CompanyLife, Short-term disability60$70K$13K

Pharmacy benefit estimate

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

$9.8M/ year

Estimated prescription spend: 4,131 participants × $2,371 national average per member. Usually higher once dependents are counted.

$255K–$628K/ year

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

Brands with a generic available$74K–$186K
Lower-cost therapeutic alternatives$109K–$227K
Generic pricing vs. actual cost$47K–$141K
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
Community Options Inc.
Sponsor EIN
22-2964056
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 22-2964056 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Community Options, Inc. 403(b) Custodial Account Plan
Type
Defined contribution plan
Participants
7,187

About this data

Source: Community Options 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 Community Options Inc..

Request a correction · Methodology