Physician practices in Pennsylvania
PlanOptica tracks 93 health and welfare plans sponsored by 77 physician practices in Pennsylvania, covering 19,255 participants and $131M in reported insurance premiums (plan year 2024 to 2025 filings). The median plan has 131 participants, and the most common size is under 100 participants (42% of plans). Most of these plans are self-funded or mixed (62%), so stop-loss and TPA relationships matter as much as the medical carrier.
Highmark Inc dominates premium with a 65% share, followed by Capital Advantage Assurance Company at 3%. Emerson Rogers, LLC is the broker of record on 13 plans, more than any other firm, ahead of Gallagher Benefit Services, Inc (10). 69% of plans report broker compensation on Schedule A; the median brokered plan pays $45K a year, about 4.2% of premium. Lancaster, Philadelphia and Allentown have the most plans.
Funding mix
- Fully insured33 · 35%
- Mixed31 · 33%
- Self-funded27 · 29%
- MEWA2 · 2%
Plan size (participants)
- Under 10039 · 42%
- 100 to 24932 · 34%
- 250 to 49913 · 14%
- 500 to 9996 · 6%
- 1,000 or more3 · 3%
Median plan: 131 participants. Median broker comp: 4.2% of premium across 64 brokered plans.
Top carriers, physicians, Pennsylvania
- 1Highmark Inc$86M32 plans · 65.4%
- 2Capital Advantage Assurance Company$4.0M5 plans · 3.0%
- 3HM Life Insurance Company$3.9M14 plans · 3.0%
- 4Upmc Health Options$3.6M1 plans · 2.7%
- 5Keystone$2.7M3 plans · 2.1%
- 6Unitedhealthcare Insurance Company$2.5M10 plans · 1.9%
- 7Delta Dental of Pennsylvania$2.3M11 plans · 1.8%
- 8Sun Life Assurance Company of Canada$2.1M7 plans · 1.6%
- 9United Healthcare Insurance Company$2.1M1 plans · 1.6%
- 10Hartford Life and Accident$1.9M5 plans · 1.5%
Top brokers, physicians, Pennsylvania
- 1Emerson Rogers, LLC13 plans$291K comp · 20.3%
- 2Gallagher Benefit Services, Inc10 plans$273K comp · 15.6%
- 3James R Nelligan & Associates9 plans$78K comp · 14.1%
- 4Usi Insurance Services LLC8 plans$417K comp · 12.5%
- 5The Meltzer Group, Inc5 plans$131K comp · 7.8%
- 6The Benecon Group, LLC5 plans$23K comp · 7.8%
- 7Img5 plans$301 comp · 7.8%
- 8The Equinox Agency4 plans$114K comp · 6.3%
- 9Bsi Corporate Benefits LLC4 plans$34K comp · 6.3%
- 10The Elite Group LLC3 plans$174K comp · 4.7%
Largest physician practices in Pennsylvania
| Employer / plan | City | Funding | Participants | Premium | Primary carrier |
|---|---|---|---|---|---|
| Trustees of the University of Pennsylvania Clinical Care Associates of the University of Pennsylvania Severance PlanAll plans | Bala Cynwyd | Self-funded | 2,427 | - | - |
| Reconstructive Orthopaedic Associates II, P.C Reconstructive Orthopaedic Associates II, P.C. Benefits PlanAll plans | Philadelphia | Fully insured | 1,275 | $17M | Blue Cross of California |
| Family Practice Center, P.C Family Practice Center PC Employee Benefit PlanAll plans | Selinsgrove | Fully insured | 1,020 | $1.3M | Equitable Financial Life Insurance Company of America |
| 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 |
| Oss Health Oss Health Welfare Benefit PlanAll plans | York | Mixed | 674 | $1.1M | Unum Life Insurance Company of America |
| Keystone Rural Health Center Keystone Rural Health Center Employee Welfare Benefit PlanAll plans | Chambersburg | Fully insured | 638 | $9.1M | Blue Cross of California |
| Mount Nittany Physician Group Mount Nittany Physician GroupAll plans | State College | Mixed | 571 | $1.1M | Blue Cross of California |
| Community Behavioral Health Community Behavioral Health Employee Welfare Benefit PlanAll plans | Philadelphia | Fully insured | 549 | $9.5M | Blue Cross of California |
| Regional Gastroenterology Associates of Lancaster Ltd Regional Gastroenterology Associates of Lancaster Ltd Health & Welfare Benefit PlanAll plans | Exton | Mixed | 529 | $829K | Prudential Insurance Company of America |
| TMS Neurohealth Centers Services, LLC TMS Neurohealth Centers Services, LLC Health and Welfare Benefit PlanAll plans | Malvern | Fully insured | 414 | $2.2M | United Healthcare Insurance Company |
| Pennsylvania Dermatology Partners Inc Pennsylvania Dermatology Partners, Inc. Health and Welfare PlansAll plans | Birdsboro | Mixed | 379 | $172K | Standard Insurance Company |
| Rgi Management Company LLC Rgi Management Health & Welfare Benefit PlanAll plans | Exton | Mixed | 377 | $447K | Prudential Insurance Company of America |
| Genesis Medical Associates, Inc Genesis Medical Associates Health and Welfare Benefit PlanAll plans | Pittsburgh | Fully insured | 369 | $3.7M | Blue Cross of California |
| Preferred Primary Care Physicians, Inc Preferred Primary Care Physicians, Inc. Health & Welfare Benefits PlanAll plans | Canonsburg | Fully insured | 358 | $462K | Blue Cross of California |
| Delaware Valley Community Health, Inc Delaware Valley Community Health, Inc. Health and Welfare PlansAll plans | Philadelphia | Fully insured | 348 | $4.6M | Blue Cross of California |
Showing 15 of 77 employers. Filter the full list by size, funding, carrier and broker.
Plans by city in Pennsylvania
- Lancaster9 plans · 956 participants
- Philadelphia8 plans · 2,544 participants
- Allentown8 plans · 911 participants
- Exton4 plans · 1,292 participants
- York4 plans · 1,032 participants
- Mansfield4 plans · 168 participants
- State College3 plans · 928 participants
- Pittsburgh3 plans · 690 participants
- Erie3 plans · 554 participants
- Camp Hill3 plans · 494 participants
- Pottstown3 plans · 300 participants
- Wyomissing3 plans · 171 participants
Frequently asked questions
How many physician practices in Pennsylvania offer an ERISA health plan?
93 health and welfare plans from 77 physician practices in Pennsylvania appear in plan year 2024 to 2025 filings on Form 5500, covering 19,255 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 physician practices in Pennsylvania?
By Schedule A premium: Highmark Inc (65% of premium, 32 plans), Capital Advantage Assurance Company (3% of premium, 5 plans) and HM Life Insurance Company (3% of premium, 14 plans).
Which benefits brokers work with physician practices in Pennsylvania?
By number of client plans: Emerson Rogers, LLC (13 plans), Gallagher Benefit Services, Inc (10 plans) and James R Nelligan & Associates (9 plans). 69% of plans report a broker.
How much do brokers earn on physician practices health plans in Pennsylvania?
The median brokered plan reports $45K a year in broker commissions and fees, or 4.2% of premium. Figures come from Schedule A, Part I.
Are physician practices health plans in Pennsylvania self-funded or fully insured?
Fully insured 35%, mixed 33% and self-funded 29%. Self-funded and mixed plans together make up 62%.
Where does this data come from?
U.S. Department of Labor Form 5500 filings and their Schedule A insurance attachments, latest filing per plan. Offices of physicians (NAICS 621111) and of mental health physicians (621112).
Prospect physician 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.
Physicians 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). Offices of physicians (NAICS 621111) and of mental health physicians (621112). Location is the sponsor's filing address in Pennsylvania.