Garnet Health Medical Center

Middletown, NY Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
4,178Participants0% vs. prior year
$9.9MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#18 of 137Health care in NYBy participants

Overview

Garnet Health Medical Center sponsors a self-funded health plan that covered 4,178 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
4,178 · prior year 4,178
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Garnet Health System Wrap Benefit Plan, plan 505 (4,178 participants)
Broker compensation
$110K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilityDeath benefitsOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Lincoln National Life Insurance CompanyLife, Short-term disability, Long-term disability1,044$780K$109K

Pharmacy benefit estimate

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

$9.9M/ year

Estimated prescription spend: 4,178 participants × $2,371 national average per member. Usually higher once dependents are counted.

$258K–$635K/ year

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

Brands with a generic available$75K–$188K
Lower-cost therapeutic alternatives$110K–$230K
Generic pricing vs. actual cost$48K–$143K
PBM contract terms$25K–$74K
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
Garnet Health Medical Center
Sponsor EIN
14-1364536
Plan number
505
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 14-1364536 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Garnet Health Medical Center 403(b) Retirement Savings Plan
Type
Defined contribution plan
Participants
5,064

About this data

Source: Garnet Health 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 Garnet Health Medical Center.

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