Complete Care

Toms River, NJ Health careNAICS 623000

Self-funded health planPlan year 2024Renews June
7,485ParticipantsFirst year on file
$17.7MEst. pharmacy spend / yrParticipants × national avg.
Jun 2027Next renewalPlan year begins June 1
#3 of 53Health care in NJBy participants

Overview

Complete Care sponsors a self-funded health plan that covered 7,485 participants in plan year 2024. The plan year starts in June. 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
7,485
Plan year
Begins June 1 · next renewal June 2027
Health plans filed
Complete Care, plan 501 (7,485 participants)
Stop-loss carrier
Sirius America Insurance Company
Broker compensation
$306K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disability

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Cigna Health and Life Insurance Company and AffiliatesDental, Vision3,377$1.9M$111K
Sirius America Insurance CompanyMedical, Stop-loss3,497$1.9M$188K
Sun Life Assurance Company of CanadaLife, Short-term disability, Long-term disability6,360$169K$7K

Pharmacy benefit estimate

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

$17.7M/ year

Estimated prescription spend: 7,485 participants × $2,371 national average per member. Usually higher once dependents are counted.

$461K–$1.1M/ year

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

Brands with a generic available$135K–$337K
Lower-cost therapeutic alternatives$197K–$412K
Generic pricing vs. actual cost$85K–$256K
PBM contract terms$44K–$133K
The DOL's PBM fee disclosure rule first applies to this plan for the plan year beginning June 2028: semiannual PBM compensation reports and an annual audit right.

Form 5500 filing details

Filing
Form 5500 with Schedule A, plan year 2024
Plan sponsor
Complete Care
Sponsor EIN
81-4423924
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 81-4423924 in the Department of Labor's EFAST2 Form 5500 search.

About this data

Source: Complete Care'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 Complete Care.

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