Kaleida Health

Buffalo, NY Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
10,125Participants+21% vs. prior year
$24.0MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#8 of 137Health care in NYBy participants

Overview

Kaleida Health sponsors a self-funded health plan that covered 10,125 participants in plan year 2025, up 21% from the prior year. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, long-term disability.

Plan type
ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
Participants
10,125 · prior year 8,351
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Kaleida Health Your Spectrum of Choices Benefit Plan, plan 520 (10,125 participants)
Broker compensation
$401K across insured contracts
MedicalLife insuranceDentalLong-term disabilityOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Sun Life and Health Insurance CompanyLife, Long-term disability8,451$4.3M$401K
ESI Employee Assistance GroupEmployee Assistance Program10,125$150K—

Pharmacy benefit estimate

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

$24.0M/ year

Estimated prescription spend: 10,125 participants × $2,371 national average per member. Usually higher once dependents are counted.

$624K–$1.5M/ year

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

Brands with a generic available$182K–$456K
Lower-cost therapeutic alternatives$266K–$557K
Generic pricing vs. actual cost$115K–$346K
PBM contract terms$60K–$180K
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
Kaleida Health
Sponsor EIN
16-1533232
Plan number
520
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 16-1533232 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Kaleida Health Savings Investment 403(b) Plan
Type
401(k) plan
Participants
12,307

About this data

Source: Kaleida 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 Kaleida Health.

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