Ophthalmology and retina practices in Pennsylvania
PlanOptica tracks 7 health and welfare plans sponsored by 7 ophthalmology and retina practices in Pennsylvania, covering 958 participants and $4.3M in reported insurance premiums (plan year 2024 to 2025 filings). The median plan has 42 participants, and the most common size is under 100 participants (86% of plans). Most of these plans are self-funded or mixed (86%), so stop-loss and TPA relationships matter as much as the medical carrier.
Independence Blue Cross dominates premium with a 67% share, followed by Northwestern Mutual at 10%. Michael J Lagowy is the broker of record on 1 plan, more than any other firm, ahead of Marsh and McLennan, LLC (1). 57% of plans report broker compensation on Schedule A; the median brokered plan pays $8K a year, about 3.3% of premium. Wyomissing, Plymouth Meeting and Monroeville have the most plans.
Funding mix
- Self-funded3 · 43%
- Mixed3 · 43%
- Fully insured1 · 14%
Plan size (participants)
- Under 1006 · 86%
- 100 to 2490 · 0%
- 250 to 4990 · 0%
- 500 to 9991 · 14%
- 1,000 or more0 · 0%
Median plan: 42 participants. Median broker comp: 3.3% of premium across 4 brokered plans.
Top carriers, ophthalmology, Pennsylvania
- 1Independence Blue Cross$2.9M1 plans · 67.0%
- 2Northwestern Mutual$436K1 plans · 10.1%
- 3Metropolitan Life Insurance Company$381K1 plans · 8.9%
- 4HM Life Insurance Company$343K2 plans · 8.0%
- 5Crum & Forster$133K1 plans · 3.1%
- 6United of Omaha Life Insurance Company$41K1 plans · 1.0%
- 7Eyemed Vision Care on Behalf of Fidelity Security Life Insurance Co$38K1 plans · 0.9%
- 8Madison National Life Insurance Co$21K1 plans · 0.5%
- 9United Concordia Insurance Company$21K2 plans · 0.5%
- 10Unum Life Insurance Company of America$4K1 plans · 0.1%
Top brokers, ophthalmology, Pennsylvania
- 1Michael J Lagowy1 plans$54K comp · 25.0%
- 2Marsh and McLennan, LLC1 plans$48K comp · 25.0%
- 3Power Kunkle Group Inc1 plans$8K comp · 25.0%
- 4Jason Espenshade1 plans$6K comp · 25.0%
- 5Guinan Financial Group, LLC1 plans$5K comp · 25.0%
- 6Employee Benefits Consultants, LLC1 plans$4K comp · 25.0%
- 7James R. Nelligan & Associates1 plans$2K comp · 25.0%
- 8North American Benefits Co1 plans$2K comp · 25.0%
- 9Pci Insurance Agency1 plans$1K comp · 25.0%
- 10Gi George Parent LP1 plans$819 comp · 25.0%
Largest ophthalmology and retina practices in Pennsylvania
| Employer / plan | City | Funding | Participants | Premium | Primary carrier |
|---|---|---|---|---|---|
| Retinovitreous Associates, Ltd. T/a Mid Atlantic Retina Retinovitreous Associates, Ltd. T/a Mid Atlantic Retina Welfare PlanAll plans | Plymouth Meeting | Fully insured | 756 | $3.7M | Blue Cross of California |
| Retina Vitreous Consultants, Inc Yourway HRA Benefit Plan of Retina Vitreous ConsultantsAll plans | Monroeville | Self-funded | 69 | - | - |
| Berks Eye Physicians & Surgeons, Ltd Berks Eye Physicians & Surgeons, Ltd. Employee Benefit PlanAll plans | Wyomissing | Mixed | 54 | $250K | HM Life Insurance Company |
| Lehigh Retina Specialists, P.C Lehigh Retina Specialists, P.C. Employee Benefit PlanAll plans | Allentown | Mixed | 42 | $167K | United States Fire Insurance Company |
| Eye Associates of Lancaster, Ltd Eye Associates of Lancaster, Ltd. Employee Benefit PlanAll plans | Lancaster | Mixed | 37 | $147K | HM Life Insurance Company |
| Bucks-Mont Eye Associates, PC Bucks-Mont Eye Associates, PC Group Health PlanAll plans | Sellersville | Self-funded | 0 | - | - |
| Carim Eye & Retina Center, Ltd Carim Eye & Retina Center, Ltd. Employee Benefit PlanAll plans | Wyomissing | Self-funded | 0 | - | - |
Plans by city in Pennsylvania
Frequently asked questions
How many ophthalmology and retina practices in Pennsylvania offer an ERISA health plan?
7 health and welfare plans from 7 ophthalmology and retina practices in Pennsylvania appear in plan year 2024 to 2025 filings on Form 5500, covering 958 participants. Plans with fewer than 100 participants that are fully insured do not have to file, so small practices are under-counted.
Which insurance carriers cover the most ophthalmology and retina practices in Pennsylvania?
By Schedule A premium: Independence Blue Cross (67% of premium, 1 plan), Northwestern Mutual (10% of premium, 1 plan) and Metropolitan Life Insurance Company (9% of premium, 1 plan).
Which benefits brokers work with ophthalmology and retina practices in Pennsylvania?
By number of client plans: Michael J Lagowy (1 plan), Marsh and McLennan, LLC (1 plan) and Power Kunkle Group Inc (1 plan). 57% of plans report a broker.
How much do brokers earn on ophthalmology and retina practices health plans in Pennsylvania?
The median brokered plan reports $8K a year in broker commissions and fees, or 3.3% of premium. Figures come from Schedule A, Part I.
Are ophthalmology and retina practices health plans in Pennsylvania self-funded or fully insured?
Self-funded 43%, mixed 43% and fully insured 14%. Self-funded and mixed plans together make up 86%.
Where does this data come from?
U.S. Department of Labor Form 5500 filings and their Schedule A insurance attachments, latest filing per plan. Ophthalmologists file as physicians (NAICS 621111), so this page matches healthcare employers by name: ophthalmology, retina, eye institute, eye center, eye associates, eye physicians, eye specialists and eye surgeons.
Prospect ophthalmology and retina practices in Pennsylvania
Open the welfare search with Pennsylvania and this sector prefilled. Narrow by participants, funding type, carrier, broker and broker compensation, then save the view or export it.
Ophthalmology in nearby states
Other healthcare specialties in Pennsylvania
Source: U.S. Department of Labor Form 5500 and Schedule A, latest filing per plan (plan years 2024-2025). Ophthalmologists file as physicians (NAICS 621111), so this page matches healthcare employers by name: ophthalmology, retina, eye institute, eye center, eye associates, eye physicians, eye specialists and eye surgeons. Location is the sponsor's filing address in Pennsylvania.