Raley's Arizona LLC
Overview
Raley's Arizona LLC sponsors a self-funded health plan that covered 2,818 participants in plan year 2025, down 28% 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.
- Plan type
- ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
- Participants
- 2,818 · prior year 3,903
- Plan year
- Begins January 1 · next renewal January 2027
- Health plans filed
- Bashas' Group Welfare Benefit Plan, plan 502 (2,818 participants)
- Broker compensation
- $330K 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 |
|---|---|---|---|---|
| Lincoln National Life Insurance Company | Long-term disability, Life | 3,038 | $1.1M | $171K |
| American Heritage Life Insurance Company | Cancer, Critical Illness | 1,780 | $1.1M | $159K |
| Vision Service Plan | Vision | 2,099 | $249K | — |
| Integrated Behavioral Health | Employee Assistance Program | 2,809 | $101K | — |
Pharmacy benefit estimate
StreamRX estimate for a plan this size. Not based on this plan's claims.
Estimated prescription spend: 2,818 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
- Raley's Arizona LLC
- Sponsor EIN
- 87-2167964
- Plan number
- 502
- Filed with
- U.S. Department of Labor (EBSA) via EFAST2
Verify this filing: search EIN 87-2167964 in the Department of Labor's EFAST2 Form 5500 search.
Retirement plan
- Plan
- Bashas' Employees Defined Benefit Pension Plan and Trust
- Type
- Pension plan
- Participants
- 4,265
About this data
Source: Raley's Arizona 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 Raley's Arizona LLC.