Orthoatlanta

Atlanta, GA Health careNAICS 621111

Self-funded health planPlan year 2025Renews January
644Participants+0% vs. prior year
$1.5MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#36 of 40Health care in GABy participants

Overview

Orthoatlanta sponsors a self-funded health plan that covered 644 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
644 · prior year 643
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Orthoatlanta Welfare Benefit Plan, plan 501 (644 participants)
Broker compensation
$249K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilityDeath benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
The Lincoln National Life Insurance CompanyLife, Short-term disability, Long-term disability618$1.2M$249K
Eyemed Vision Care on Behalf of Fidelity Security Life Insurance Co.Vision761$33K—

Pharmacy benefit estimate

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

$1.5M/ year

Estimated prescription spend: 644 participants × $2,371 national average per member. Usually higher once dependents are counted.

$40K–$98K/ year

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

Brands with a generic available$12K–$29K
Lower-cost therapeutic alternatives$17K–$35K
Generic pricing vs. actual cost$7K–$22K
PBM contract terms$4K–$11K
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
Orthoatlanta
Sponsor EIN
03-0482395
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 03-0482395 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Orthoatlanta 401(k) Profit Sharing Plan
Type
401(k) plan
Participants
861

About this data

Source: Orthoatlanta'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 Orthoatlanta.

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