Presbyterian Healthcare Services

Albuquerque, NM Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
14,501Participants+2% vs. prior year
$34.4MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#1 of 7Health care in NMBy participants

Overview

Presbyterian Healthcare Services sponsors a self-funded health plan that covered 14,501 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, long-term disability, and more.

Plan type
ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
Participants
14,501 · prior year 14,272
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Presbyterian Healthcare Services Custom Benefits Plan, plan 509 (14,501 participants)
Broker compensation
$2.2M across insured contracts
MedicalLife insuranceDentalVisionLong-term disabilitySeveranceDeath benefitsOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Delta Dental of New MexicoDental21,096$7.2M—
Minnesota Life Insurance CompanyLife17,392$5.9M$468K
Continental American Insurance CompanyAccident, Critical Illness, Hospital5,176$3.3M$1.5M
Lincoln National Life Insurance CompanyLong-term disability13,111$3.2M$177K
Eyemed Vision Care on Behalf of Fidelity Security Life Insurance Co.Vision18,687$854K$28K
Presbyterian Healthcare Services D.b.a. the Solutions GroupEmployee Assistance Program14,501$443K—
National Union Fire Ins. Co. of Pittsburgh, PABusiness Travel Accident14,501$8K$2K

Pharmacy benefit estimate

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

$34.4M/ year

Estimated prescription spend: 14,501 participants × $2,371 national average per member. Usually higher once dependents are counted.

$894K–$2.2M/ year

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

Brands with a generic available$261K–$653K
Lower-cost therapeutic alternatives$382K–$798K
Generic pricing vs. actual cost$165K–$495K
PBM contract terms$86K–$258K
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
Presbyterian Healthcare Services
Sponsor EIN
85-0105601
Plan number
509
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 85-0105601 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Presbyterian Healthcare Services 403(b) Plan
Type
Defined contribution plan
Participants
20,534

About this data

Source: Presbyterian Healthcare Services'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 Presbyterian Healthcare Services.

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