Potbelly Sandwich Works, LLC
Overview
Potbelly Sandwich Works, LLC sponsors a self-funded health plan that covered 1,748 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
- 1,748 · prior year 1,748
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Potbelly Sandwich Works Employee Benefit Plan, plan 501 (1,748 participants)
- Broker compensation
- $416K 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 |
|---|---|---|---|---|
| Unum Insurance Company | Critical Illness, Hospital, Accident | 954 | $602K | $330K |
| Unum Life Insurance Company of America | Life, Short-term disability, Long-term disability | 1,609 | $413K | $38K |
| Cigna Health and Life Insurance Company and Affiliates | Dental | 822 | $388K | $38K |
| Eyemed Vision on Behalf of Fidelity Security Life Insurance Company | Vision | 987 | $51K | $10K |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 1,748 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
- Potbelly Sandwich Works, LLC
- Sponsor EIN
- 36-4063453
- Plan number
- 501
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 36-4063453 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Potbelly Sandwich Works 401(k) Plan
- Type
- 401(k) plan
- Participants
- 5,668
About this data
Source: Potbelly Sandwich Works, 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 Potbelly Sandwich Works, LLC.