Door County Memorial Hospital DBA Door County Medical Center
Overview
Door County Memorial Hospital DBA Door County Medical Center sponsors a self-funded health plan that covered 506 participants in plan year 2025, about the same as 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
- 506 · prior year 516
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Door County Memorial Hospital Wrap Plan, plan 504 (506 participants)
- Stop-loss carrier
- Berkley Life
- Broker compensation
- $205K 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 |
|---|---|---|---|---|
| Berkley Life | Stop-loss | 506 | $806K | — |
| Sun Life Assurance Company of Canada | Life, Short-term disability, Long-term disability | 661 | $787K | $181K |
| Provident Life and Accident Insurance Company | Disability, Life | 155 | $112K | $15K |
| Metropolitan Life Insurance Company | Vision | 1,422 | $99K | $9K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 506 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
- Door County Memorial Hospital DBA Door County Medical Center
- Sponsor EIN
- 39-0806324
- Plan number
- 504
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 39-0806324 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Door County Memorial Hospital Tax Deferred Annuity Plan
- Type
- Defined contribution plan
- Participants
- 1,135
About this data
Source: Door County Memorial Hospital DBA Door County Medical Center'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 Door County Memorial Hospital DBA Door County Medical Center.