Pikeville Medical Center, Inc.

Pikeville, KY Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
3,182Participants+4% vs. prior year
$7.5MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#10 of 33Health care in KYBy participants

Overview

Pikeville Medical Center, Inc. sponsors a self-funded health plan that covered 3,182 participants in plan year 2025, up 4% from the prior year. The plan year starts in January. Alongside medical, its benefits filing reports life insurance, dental, short-term disability, long-term disability, and more.

Plan type
ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
Participants
3,182 · prior year 3,069
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Pikeville Medical Center Group Insurance Plan, plan 501 (3,182 participants)
Broker compensation
$66K across insured contracts
MedicalLife insuranceDentalShort-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
Delta Dental of KentuckyDental6,683$1.3M—
American United Life Insurance CompanyLife, Long-term disability3,182$1.3M$66K

Pharmacy benefit estimate

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

$7.5M/ year

Estimated prescription spend: 3,182 participants × $2,371 national average per member. Usually higher once dependents are counted.

$196K–$484K/ year

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

Brands with a generic available$57K–$143K
Lower-cost therapeutic alternatives$84K–$175K
Generic pricing vs. actual cost$36K–$109K
PBM contract terms$19K–$57K
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
Pikeville Medical Center, Inc.
Sponsor EIN
61-0458376
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 61-0458376 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Retirement Plan for Employees of Pikeville Medical Center, Inc.
Type
Defined contribution plan
Participants
4,114

About this data

Source: Pikeville Medical Center, Inc.'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 Pikeville Medical Center, Inc..

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