Pacifica Hospital of the Valley
Overview
Pacifica Hospital of the Valley sponsors a self-funded health plan that covered 522 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.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 522 · prior year 523
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Pacifica Hospital of the Valley Medical Plan, plan 502 (522 participants)
- Broker compensation
- $67K across insured contracts
Insurance carriers
Insured coverage reported on Schedule A. Self-funded medical claims aren't reported there.
| Carrier | Coverage | Covered | Premium | Broker comp |
|---|---|---|---|---|
| Access Dental Plan CA | Dental, Vision | 922 | $695K | $56K |
| Colonial Life & Accident Insurance Company | Life | 474 | $60K | $6K |
| Fidelity Security Life Insurance Company | Dental, Vision | 922 | $60K | $5K |
| Premier Access Insurance Company | Dental, Vision | 922 | $518 | $42 |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 522 participants × $2,371 national average per member. Usually higher once dependents are counted.
Typical savings opportunity found in independent reviews of plans this size.
Form 5500 filing details
- Filing
- Form 5500 with Schedule A, plan year 2025
- Plan sponsor
- Pacifica Hospital of the Valley
- Sponsor EIN
- 33-0737312
- Plan number
- 502
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 33-0737312 in the Department of Labor's EFAST2 Form 5500 search.
About this data
Source: Pacifica Hospital of the Valley'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 Pacifica Hospital of the Valley.