Prime Healthcare Foundation, Inc.

Ontario, CA Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
11,047Participants+57% vs. prior year
$26.2MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#9 of 68Health care in CABy participants

Overview

Prime Healthcare Foundation, Inc. sponsors a self-funded health plan that covered 11,047 participants in plan year 2025, up 57% from 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
11,047 · prior year 7,045
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Prime Healthcare Foundation Welfare Benefits Plan, plan 507 (11,047 participants)
Broker compensation
$515K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilityOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Lincoln National Life Insurance CompanyLife, Short-term disability, Long-term disability11,047$3.8M$398K
Delta Dental of CaliforniaDental6,535$2.3M$117K
Vision Service PlanVision3,873$601K—

Pharmacy benefit estimate

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

$26.2M/ year

Estimated prescription spend: 11,047 participants × $2,371 national average per member. Usually higher once dependents are counted.

$681K–$1.7M/ year

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

Brands with a generic available$199K–$498K
Lower-cost therapeutic alternatives$291K–$608K
Generic pricing vs. actual cost$126K–$377K
PBM contract terms$65K–$196K
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
Prime Healthcare Foundation, Inc.
Sponsor EIN
20-8065139
Plan number
507
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 20-8065139 in the Department of Labor's EFAST2 Form 5500 search.

About this data

Source: Prime Healthcare Foundation, 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 Prime Healthcare Foundation, Inc..

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