Professional Orthopedic & Sports Physical Therapy PC

Melville, NY Health careNAICS 621340

Self-funded health planPlan year 2025Renews January
684Participants+6% vs. prior year
$1.6MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#107 of 137Health care in NYBy participants

Overview

Professional Orthopedic & Sports Physical Therapy PC sponsors a self-funded health plan that covered 684 participants in plan year 2025, up 6% 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
684 · prior year 647
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Professional Orthopedic & Sports Physical Therapy Benefit Plan, plan 504 (684 participants)
Stop-loss carrier
Amalgamated Life Insurance Co.
Broker compensation
$354K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityLong-term disabilityDeath benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Amalgamated Life Insurance Co.Medical, Stop-loss684$592K$262K
First Unum Life Insurance Co.Long-term disability230$314K$46K
GuardianDental, Life1,033$170K$22K
Provident Life and Casualty Insurance Co.Short-term disability, Specified Disease, Hospital EE Paid298$128K$12K
Fidelity Secuity Life Insurance Company of NYVision1,065$82K$12K

Pharmacy benefit estimate

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

$1.6M/ year

Estimated prescription spend: 684 participants × $2,371 national average per member. Usually higher once dependents are counted.

$42K–$104K/ year

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

Brands with a generic available$12K–$31K
Lower-cost therapeutic alternatives$18K–$38K
Generic pricing vs. actual cost$8K–$23K
PBM contract terms$4K–$12K
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
Professional Orthopedic & Sports Physical Therapy PC
Sponsor EIN
11-3431170
Plan number
504
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 11-3431170 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Professional Orthopedic and Sports Physical Therapy, P.C. Employee Savings Plan
Type
401(k) plan
Participants
1,660

About this data

Source: Professional Orthopedic & Sports Physical Therapy PC'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 Professional Orthopedic & Sports Physical Therapy PC.

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