H20 Innovation USA, Inc.
Overview
H20 Innovation USA, Inc. sponsors a self-funded health plan that covered 869 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
- 869 · prior year 869
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- H20 Innovation Health and Welfare Benefit Plan, plan 510 (869 participants)
- Broker compensation
- $155K 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 |
|---|---|---|---|---|
| United of Omaha Life Insurance Company | Accident, Critical Illness, Life, Long-term disability, Short-term disability | 850 | $514K | $98K |
| Cigna Health and Life Insurance Company and Affiliates | Dental | 592 | $349K | $41K |
| Sun Life Assurance Company of Canada | Vision | 535 | $70K | $10K |
| United of Omaha Life Insurance | Hospital Indemnity | 103 | $29K | $6K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 869 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
- H20 Innovation USA, Inc.
- Sponsor EIN
- 20-5584930
- Plan number
- 510
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 20-5584930 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- H2o Innovation 401(k) Plan
- Type
- 401(k) plan
- Participants
- 958
About this data
Source: H20 Innovation USA, 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 H20 Innovation USA, Inc..