Umass Memorial Health Care, Inc.

Worcester, MA Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
17,096Participants+14% vs. prior year
$40.5MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#3 of 40Health care in MABy participants

Overview

Umass Memorial Health Care, Inc. sponsors a self-funded health plan that covered 17,096 participants in plan year 2025, up 14% 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
17,096 · prior year 14,929
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Umass Memorial Healthcare Group Welfare Benefit Plan, plan 501 (17,096 participants)
Broker compensation
$630K across insured contracts
MedicalLife insuranceDentalVisionShort-term disabilityPrepaid legalLong-term disabilityDeath benefitsOther welfare benefits

Insurance carriers

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

CarrierCoverageCoveredPremiumBroker comp
Reliance Standard Life Insurance CompanyLong-term disability, Life, Accidental Death and Dismemberment, Weekly Income15,263$12.7M$533K
Eyemed Vision Care on Behalf of Fidelity Security Life Insurance Co.Vision22,799$1.4M$7K
Metropolitan General Insurance CompanyLegal3,395$642K$81K
United Behavioral Health DBA OptumEmployee Assistance Program20,831$312K—
Provident Life and Accident Insurance CompanyLong-term disability58$286K$5K
Metropolitan Life Insurance CompanyLife53$125K—
Petersen International UnderwritersLong-term disability41$119K$5K

Pharmacy benefit estimate

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

$40.5M/ year

Estimated prescription spend: 17,096 participants × $2,371 national average per member. Usually higher once dependents are counted.

$1.1M–$2.6M/ year

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

Brands with a generic available$308K–$770K
Lower-cost therapeutic alternatives$450K–$940K
Generic pricing vs. actual cost$195K–$584K
PBM contract terms$101K–$304K
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
Umass Memorial Health Care, Inc.
Sponsor EIN
04-3358566
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 04-3358566 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Umass Memorial Health Care 401(k) Plan
Type
401(k) plan
Participants
18,337

About this data

Source: Umass Memorial Health Care, 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 Umass Memorial Health Care, Inc..

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