Valley Children's Hospital

Madera, CA Health careNAICS 622000

Self-funded health planPlan year 2025Renews January
3,559Participants+3% vs. prior year
$8.4MEst. pharmacy spend / yrParticipants × national avg.
Jan 2027Next renewalPlan year begins January 1
#23 of 68Health care in CABy participants

Overview

Valley Children's Hospital sponsors a self-funded health plan that covered 3,559 participants in plan year 2025, up 3% 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
3,559 · prior year 3,441
Plan year
Begins January 1 · next renewal January 2027
Health plans filed
Valley Children's Hospital Employee Health Care Plan, plan 501 (3,559 participants)
Broker compensation
$188K 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
The Lincoln National Life Insurance CompanyLong-term disability3,500$559K$45K
Hartford Life and AccidentLife3,500$272K$115K

Pharmacy benefit estimate

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

$8.4M/ year

Estimated prescription spend: 3,559 participants × $2,371 national average per member. Usually higher once dependents are counted.

$219K–$541K/ year

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

Brands with a generic available$64K–$160K
Lower-cost therapeutic alternatives$94K–$196K
Generic pricing vs. actual cost$41K–$122K
PBM contract terms$21K–$63K
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
Valley Children's Hospital
Sponsor EIN
94-1294954
Plan number
501
Filed with
U.S. Department of Labor (EBSA) via EFAST2

Verify this filing: search EIN 94-1294954 in the Department of Labor's EFAST2 Form 5500 search.

Retirement plan

Plan
Valley Children's Hospital Defined Contribution Retirement Plan
Type
Defined contribution plan
Participants
5,372

About this data

Source: Valley Children's Hospital'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 Valley Children's Hospital.

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