Eclinicalworks

Westborough, MA Professional servicesNAICS 541512

Self-funded health planPlan year 2024Renews September
1,492ParticipantsFirst year on file
$3.5MEst. pharmacy spend / yrParticipants × national avg.
Sep 2027Next renewalPlan year begins September 1
#10 of 39Professional services in MABy participants

Overview

Eclinicalworks sponsors a self-funded health plan that covered 1,492 participants in plan year 2024. The plan year starts in September. 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
1,492
Plan year
Begins September 1 · next renewal September 2027
Health plans filed
Eclinicalworks Employee Benefits Plan, plan 501 (1,492 participants)
Stop-loss carrier
Blue Cross Blue Shield of Massachusetts, Inc.; The North River Insurance Company
Broker compensation
$192K 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
Prudential Insurance Company of AmericaHospital Indemnity, Life, Voluntary Life, Accidental Death and Dismemberment, Voluntary AD&D, Long-term disability, Accident, Critical Illness1,507$550K$74K
Eyemed Vision Care on Behalf Ofidelity Security Life Insurance CompanyVision3,077$127K$10K
Abacus Health Solutions, LLCWellness, Diabetes Care Management97$52K—
Blue Cross Blue Shield of Massachusetts, Inc.Stop-loss3,148—$51K

Pharmacy benefit estimate

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

$3.5M/ year

Estimated prescription spend: 1,492 participants × $2,371 national average per member. Usually higher once dependents are counted.

$92K–$227K/ year

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

Brands with a generic available$27K–$67K
Lower-cost therapeutic alternatives$39K–$82K
Generic pricing vs. actual cost$17K–$51K
PBM contract terms$9K–$27K
The DOL's PBM fee disclosure rule first applies to this plan for the plan year beginning September 2027: semiannual PBM compensation reports and an annual audit right.

Form 5500 filing details

Filing
Form 5500 with Schedule A, plan year 2024
Plan sponsor
Eclinicalworks
Sponsor EIN
04-3461392
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 04-3461392 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Eclinicalworks Profit Sharing 401(k) Plan
Type
401(k) plan
Participants
1,874

About this data

Source: Eclinicalworks'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 Eclinicalworks.

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