Fareway Stores, Inc.
Overview
Fareway Stores, Inc. sponsors a self-funded health plan that covered 2,525 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, short-term disability.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 2,525 · prior year 2,478
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Fareway Stores, Inc. Group Insurance Benefits Plan, plan 504 (2,525 participants)
- Stop-loss carrier
- Wellmark Blue Cross and Blue Shield of Iowa
- Broker compensation
- $85K 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 |
|---|---|---|---|---|
| Wellmark Blue Cross and Blue Shield of Iowa | Medical, Prescription drug, PPO, Stop-loss | 2,526 | $28.7M | — |
| Hartford Life & Accident | Life | 2,993 | $631K | — |
| Principal Life Insurance Company | Long-term disability | 1,269 | $535K | — |
| American Heritage Life Insurance Company | Medical | 1,437 | $526K | $85K |
| Fidelity Security Life Insurance Company | Vision | 2,000 | $262K | — |
| Delta Dental of Iowa | Dental | 2,454 | — | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 2,525 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
- Fareway Stores, Inc.
- Sponsor EIN
- 42-0240920
- Plan number
- 504
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 42-0240920 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Fareway Stores, Inc. 401(k) Profit Sharing Plan
- Type
- 401(k) plan
- Participants
- 8,142
About this data
Source: Fareway Stores, 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 Fareway Stores, Inc..