Legacy Health

Portland, OR Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
12,872Participants-1% vs. prior year
$30.5MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#1 of 25Health care in ORBy participants

Overview

Legacy Health sponsors a self-funded health plan that covered 12,872 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
12,872 · prior year 12,977
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Legacy Health System Welfare Benefits Plan Unfunded, plan 504 (12,872 participants)
Broker compensation
$754K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilitySeveranceDeath benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Continental American Insurance CompanyShort-term disability465$2.4M$469K
Combined InsuranceLong Term Care & Life Insurance1,230$911K$99K
Arag Insurance CompanyLegal Insurance3,408$390K$51K

Pharmacy benefit estimate

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

$30.5M/ year

Estimated prescription spend: 12,872 participants × $2,371 national average per member. Usually higher once dependents are counted.

$794K–$2.0M/ year

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

Brands with a generic available$232K–$580K
Lower-cost therapeutic alternatives$339K–$708K
Generic pricing vs. actual cost$146K–$439K
PBM contract terms$76K–$229K
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
Legacy Health
Sponsor EIN
23-7426300
Plan number
504
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 23-7426300 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Legacy Health 403(b) Plan
Type
Defined contribution plan
Participants
20,640

About this data

Source: Legacy 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 Legacy Health.

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