Essentia Health

Duluth, MN Health careNAICS 622000

Self-funded health planPlan year 2025Renews JanuaryCollectively bargained
13,833Participants+4% vs. prior year
$32.8MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#4 of 50Health care in MNBy participants

Overview

Essentia Health sponsors a self-funded health plan that covered 13,833 participants in plan year 2025, up 4% 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
13,833 · prior year 13,276
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Essentia Health Welfare Benefit Plan, plan 501 (13,833 participants)
Broker compensation
$978K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilitySeveranceDeath benefitsOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
The Lincoln National Life Insurance CompanyLife, Short-term disability, Long-term disability, Accident, Critical Illness, Hospital Indemnity13,833$11.1M$974K
Fidelity Security Life Insurance CompanyVision12,908$1.2M—
Berkley Life and Health Insurance CompanyBusiness Travel Accident13,833$22K$4K

Pharmacy benefit estimate

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

$32.8M/ year

Estimated prescription spend: 13,833 participants × $2,371 national average per member. Usually higher once dependents are counted.

$853K–$2.1M/ year

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

Brands with a generic available$249K–$623K
Lower-cost therapeutic alternatives$364K–$761K
Generic pricing vs. actual cost$157K–$472K
PBM contract terms$82K–$246K
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
Essentia Health
Sponsor EIN
20-0360007
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 20-0360007 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Essentia Health Retirement Plan
Type
401(k) plan
Participants
21,072

About this data

Source: Essentia Health'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 Essentia Health.

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