The Sycuan Band of the Kumeyaay Nation

El Cajon, CA Arts & recreationNAICS 713200

Self-funded health planPlan year 2025Renews January
2,900Participants0% vs. prior year
$6.9MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#1 of 10Arts & recreation in CABy participants

Overview

The Sycuan Band of the Kumeyaay Nation sponsors a self-funded health plan that covered 2,900 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, prepaid legal, and more.

Plan type
ERISA welfare benefit plan, self-funded (benefits paid from employer assets or a trust)
Participants
2,900 · prior year 2,900
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
The Sycuan Band of the Kumeyaay Nation, plan 501 (2,900 participants)
MedicalLife insuranceDentalVisionPrepaid legalLong-term disabilityDeath benefitsOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Anthem Blue Cross Life and Health Ins Co.Employee Assistance Program2,900——
Symetra Life Insurance CompanyLife, Long-term disability2,900——
MetLifeLegal2,900——

Pharmacy benefit estimate

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

$6.9M/ year

Estimated prescription spend: 2,900 participants × $2,371 national average per member. Usually higher once dependents are counted.

$179K–$441K/ year

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

Brands with a generic available$52K–$131K
Lower-cost therapeutic alternatives$76K–$160K
Generic pricing vs. actual cost$33K–$99K
PBM contract terms$17K–$52K
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
The Sycuan Band of the Kumeyaay Nation
Sponsor EIN
95-3066162
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 95-3066162 in the Department of Labor's EFAST2 Form 5500 search.

About this data

Source: The Sycuan Band of the Kumeyaay Nation'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 The Sycuan Band of the Kumeyaay Nation.

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