Optalis Professional Services, LLC

Novi, MI Health careNAICS 623000

Self-funded health planPlan year 2025Renews January
3,759Participants+13% vs. prior year
$8.9MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#6 of 27Health care in MIBy participants

Overview

Optalis Professional Services, LLC sponsors a self-funded health plan that covered 3,759 participants in plan year 2025, up 13% from 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
3,759 · prior year 3,316
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Optalis Professional Services, LLC Welfare Benefit Plan, plan 501 (3,759 participants)
Broker compensation
$466K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityPrepaid legalLong-term disabilityDeath benefitsOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Metropolitan Life Insurance CompanyDental, Vision, Life, Short-term disability, Long-term disability, Hospital, Accident, Critical Illness5,365$3.2M$448K
Metropolitan General Insurance CompanyLegal470$82K$18K

Pharmacy benefit estimate

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

$8.9M/ year

Estimated prescription spend: 3,759 participants × $2,371 national average per member. Usually higher once dependents are counted.

$232K–$571K/ year

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

Brands with a generic available$68K–$169K
Lower-cost therapeutic alternatives$99K–$207K
Generic pricing vs. actual cost$43K–$128K
PBM contract terms$22K–$67K
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
Optalis Professional Services, LLC
Sponsor EIN
84-2318500
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 84-2318500 in the Department of Labor's EFAST2 Form 5500 search.

About this data

Source: Optalis Professional Services, LLC'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 Optalis Professional Services, LLC.

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