Orthoalliance

Cincinnati, OH Health careNAICS 621111

Self-funded health planPlan year 2025Renews January
1,583Participants-10% vs. prior year
$3.8MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#41 of 89Health care in OHBy participants

Overview

Orthoalliance sponsors a self-funded health plan that covered 1,583 participants in plan year 2025, down 10% 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
1,583 · prior year 1,757
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Orthoalliance Employee Benefits Plan, plan 501 (1,583 participants)
Broker compensation
$307K 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
Life Insurance Company of North AmericaLong-term disability, Short-term disability, Accidental Death & Dismemberment, Life2,073$1.5M$216K
Superior Dental CareDental2,095$620K$24K
Reliastar Life Insurance CompanyAccident and Critical Illness610$162K$32K
Fidelity Security Life Insurance CompanyVision1,924$142K$35K
Bethesda Healthcare,inc. D.b.a. Trihealth EAPEmployee Assistance Program1,960$40K—

Pharmacy benefit estimate

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

$3.8M/ year

Estimated prescription spend: 1,583 participants × $2,371 national average per member. Usually higher once dependents are counted.

$98K–$241K/ year

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

Brands with a generic available$29K–$71K
Lower-cost therapeutic alternatives$42K–$87K
Generic pricing vs. actual cost$18K–$54K
PBM contract terms$9K–$28K
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
Orthoalliance
Sponsor EIN
84-2250518
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 84-2250518 in the Department of Labor's EFAST2 Form 5500 search.

About this data

Source: Orthoalliance'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 Orthoalliance.

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